Randomized comparison of biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents for percutaneous coronary revascularization: Rationale and design of the BIOSCIENCE trial.

BACKGROUND: Biodegradable polymers for release of antiproliferative drugs from metallic drug-eluting stents aim to improve long-term vascular healing and efficacy. We designed a large scale clinical trial to compare a novel thin strut, cobalt-chromium drug-eluting stent with silicon carbide-coating releasing sirolimus from a biodegradable polymer (O-SES, Orsiro; Biotronik, Bülach, Switzerland) with the durable polymer-based Xience Prime/Xpedition everolimus-eluting stent (EES) (Xience Prime/Xpedition stent, Abbott Vascular, IL) in an all-comers patient population. DESIGN: The multicenter BIOSCIENCE trial (NCT01443104) randomly assigned 2,119 patients to treatment with biodegradable polymer sirolimus-eluting stents (SES) or durable polymer EES at 9 sites in Switzerland. Patients with chronic stable coronary artery disease or acute coronary syndromes, including non-ST-elevation and ST-elevation myocardial infarction, were eligible for the trial if they had at least 1 lesion with a diameter stenosis >50% appropriate for coronary stent implantation. The primary end point target lesion failure (TLF) is a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization within 12 months. Assuming a TLF rate of 8% at 12 months in both treatment arms and accepting 3.5% as a margin for noninferiority, inclusion of 2,060 patients would provide more than 80% power to detect noninferiority of the biodegradable polymer SES compared with the durable polymer EES at a 1-sided type I error of 0.05. Clinical follow-up will be continued through 5 years. CONCLUSION: The BIOSCIENCE trial will determine whether the biodegradable polymer SES is noninferior to the durable polymer EES with respect to TLF.

Kulutus- korroosionkestävien materiaalien laserpinnoitus

Diplomityössä tutkitaan kulutus- ja korrosionkestävien materiaalien laserpinnoitusta. Laserpinnoituksessa sulatetaan uutta materiaalia työkappaleen pintaan lasersäteen avulla. Tarkoituksena on yleensä parantaa pinnan korroosion, kulumisen tai pintapaineen kestävyyttä. Laserpinnoitukseen liittyy useita etuja verrattuna konventionaalisiin päällehitsausprosesseihin. Työssä tutkittavat pinnoitemateriaalit ovat kobolttipohjaiset Stellite 1 ja Stellite 6, työkaluteräkset WR 4 ja WR 6 sekä metallimatriisikomposiitti Anval50/50+30 % Cr3C2. Pinnoitettavat perusaineet ovat hiiliteräs Fe 52, ruostumaton teräs AISI 316 ja valurauta GRP 500. Työn tavoitteena on löytää kunkin pinnoite/perusaine-yhdistelmän pinnoitusparametrit. Pinnoituskokeissa käytettiin LTKK:n 6 kW:n CO2-laseria. Pinnoitetuille koekappeleille tehtiin kovuusmittaukset ja kulutuskokeet. Pinnoitteiden mikrorakenteet analysoitiin ja sekoittumisasteet laskettiin. Virheitä tutkittiin silmämääräisesti sekä radiografisella kuvauksella. Optimiparametreja pinnoitemateriaaleille ei löydetty. Pinnoitteiden sekoittumisasteet muodostuivat suuriksi liiallisen lasertehon ja/tai huonon lisäaineen kohdistuksen vuoksi. Suuri sekoittuminen alensi pinnoitteiden kovuutta ja kulumiskestävyyttä. Pinnoitusparametreja arvioidaan koetulosten perusteella ja niille annetaan korjausehdotuksia. Lopuksi esitetään suosituksia tutkimusprojektin jatkotoimille.

Influência da técnica de fabricação e dos materiais sobre o ajuste da interface pilar/implante em infraestruturas implantossuportadas

The aim of this study was to compare the misfit vertical, horizontal and passivity of zirconia and cobalt-chromium frameworks fabricated for CAD / CAM technology and conventional method of casting. Sixteen frameworks in one-piece, were obtained from a metallic matrix containing three Brånemark compatible implants with regular platform (Titamax Cortical Ti, Neodent). Eight frameworks were fabricated by CAD / CAM system (NeoShape, Neodent): four in zirconia (ZirCAD) and four cobalt-chromium (CoCrcad). Eight other frameworks were obtained by conventional casting method: four cobalt-chromium with UCLA abutment premachined Co-Cr (CoCrUCci) and four cobalt-chromium with UCLA abutment castable (CoCrUCc). The fit vertical, horizontal and passivity by one-screw test were measured using scanning electron microscopy with magnification of 250x. Initially evaluated the passivity by one-screw test and subsequently to assess the vertical and horizontal misfit, tightened all the screws with a torque of 20 Ncm. Mean, standard deviation, minimum and maximum values were calculated for each group. Measurements of horizontal misfit were transformed into cumulative frequency for categorization of the variable and the group later comparison groups. To evaluate the existence of quantitative differences between the groups tested for vertical misfit and passivity, we used the Kruskal-Wallis test. The Mann-Whitney test was used to compare group to group statistical differences (p <0.05). Were observed the respective mean and standard deviation for vertical misfit and passivity in micrometers: ZirCAD (5.9 ± 3.6, 107.2 ± 36), CoCrcad (1.2 ± 2.2, 107.5 ± 26 ), CoCrUCci (11.8 ± 9.8, 124.7 ± 74), CoCrUCc (12.9 ± 11.0, 108.8 ± 85). There were statistical differences in measures of vertical misfit (p = 0.000). The Mann-Whitney test revealed statistical differences (p <0.05) between all groups except between CoCrUCci and CoCrUCc (p = 0.619). No statistical difference was observed for the passivity. In relation to the horizontal misfit groups ZirCAD and CoCrcad did not show best values in relation to CoCrUCci and CoCrUCc. Based on the results it can be concluded that frameworks fabricated by CAD / CAM technology had better values of vertical fit than those manufactured by the casting method, nevertheless, the passivity was not influenced by manufacturing technique and material used. The horizontal fit obtained by frameworks manufactured by CAD / CAM was not superior to those manufactured by casting. A lower variability in vertical adjustment and passivity was observed when frameworks were fabricated by CAD / CAM technology

Passividade na interface prótese/pilar intermediário de infraestrutura implantossuportadas confeccionadas pela tecnologia CAD/CAM e método convencional

The objective of this research was to evaluate the passivity and strain induced in infrastructures screwed on abutments, made by CAD/CAM technology, and to compare these samples with parts manufactured by conventional casting. Using CAD/CAM technology, 4 samples were made from zirconia (Zircad) and 4 samples were manufactured from cobaltchrome (CoCrcad). The control groups were 4 specimens of cobalt-chrome, made by onepiece casting (CoCrci), for a total of 12 infrastructures. To evaluate the passivity, the infraestructures were installed on the abutments. One end was tightened and the vertical gap between the infrastructure and the prosthetic abutment was measured with scanning electron microscopy (250×). The mean strain in these infrastructures was analyzed via the photoelasticity test. A significant difference (p = 0.000) in passivity was observed between the control (CoCrci) and sample groups (CoCrcad and CoCrci). CoCrcad exhibited the best value of passivity (48.76 ± 13.45 μm) and CoCrci the worst (187.55 ± 103.63 μm), Zircad presented an intermediate value (103.81 ± 43.15 μm). When compared to the other groups, CoCrci showed the highest mean strain around the implants (17.19 ± 7.22 kPa). It was concluded that the zirconia infrastructure made by CAD / CAM showed a higher vertical marginal misfit than those made in cobalt-chromium alloy with the same methodology, however, the tension generated in the implants was similar. The CAD/CAM technology is more accurate for passivity and mean strain of infrastructure screwed on abutments than conventional manufacturing techniques

Preload Evaluation of Different Screws in External Hexagon Joint

Purpose: This study compared the maintenance of tightening torque in different retention screw types of implant-supported crowns.Materials and Methods: Twelve metallic crowns in UCLA abutments cast with cobalt-chromium alloy were attached to external hexagon osseointegrated implants with different retention screws: group A: titanium alloy retention screw; group B: gold alloy retention screw with gold coating; group C: titanium alloy retention screw with diamond-like carbon film coating; and group D: titanium alloy retention screw with aluminum titanium nitride coating. Three detorque measurements were obtained after torque insertion in each replica. Data were evaluated by analysis of variance (ANOVA), Tukey's test (P < 0.05), and t test (P < 0.05).Results: Detorque value reduced in all groups (P < 0.05). Group A retained the highest percentage of torque in comparison with the other groups (P < 0.05). Groups B and D retained the lowest percentage of torque without statistically significant difference between them (P < 0.05).Conclusions: All screw types exhibited reduction in the detorque value. The titanium screw maintained the highest percentage of torque whereas the gold-coated screw and the titanium screw with aluminum titanium nitride coating retained the lowest percentage. (Implant Dent 2012;21:46-50)

The Effect of Mechanical Cycling and Different Misfit Levels on Vicker's Microhardness of Retention Screws for Single Implant-Supported Prostheses

Purpose: The aim of this study was to evaluate the effect of mechanical cycling and different misfit levels on Vicker's microhardness of retention screws for single implant-supported prostheses.Materials and Methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n = 12). The crowns presented no misfit in group A (control group) and unilateral misfits of 50 mu m, 100 mu m, and 200 mu m in groups B, C, and D, respectively. The crowns were screwed to external hexagon implants with titanium retention screws (torque of 30 N/cm), and the sets were submitted to three different periods of mechanical cycling: 2 x 10(4), 5 x 10(4), and 1 x 10(6) cycles. Screw microhardness values were measured before and after each cycling period. Data were evaluated by two-way ANOVA and Tukey's test (p < 0.05).Results: Mechanical cycling statistically reduced microhardness values of retention screws regardless of cycling periods and groups. In groups A, B, and C, initial microhardness values were statistically different from final microhardness values (p < 0.05). There was no statistically significant difference for initial screw microhardness values (p > 0.05) among the groups; however, when the groups were compared after mechanical cycling, a statistically significant difference was observed between groups B and D (p < 0.05).Conclusions: Mechanical cycling reduced the Vicker's microhardness values of the retention screws of all groups. The crowns with the highest misfit level presented the highest Vicker's microhardness values.

Shear bond strength of aesthetic materials bonded to Ni-Cr alloy

Objectives. This study was undertaken to evaluate the shear bond strength of four materials used as aesthetic material bonded to Ni-Cr alloy.Methods. Sixty-eight alloy discs were prepared and divided equally into four groups, and received four treatments for veneering: conventional feldspathic porcelain (Noritake EX-3) and three light-cured prosthodontic composite resins (Artglass, Solidex and Targis). The aesthetic materials were applied after metal structure conditioning in accordance with the manufacturers' recommendations. The specimens were stored in distilled water at 37 degreesC for 7 days. A universal testing machine was used to measure the shear bond strength of the specimens at a cross head speed of 0.5 mm/min. Fractured specimens were examined by using both optical and scanning electron microscope.Results. The analysis of variance and Tukey's test showed that the strongest mean shear bond was obtained with Noritake EX-3 (mean shear bond strength 42.90 +/- 7.82 MPa). For composites, the highest mean shear bond strength was observed for Targis (12.30 +/- 1.57 MPa); followed by Solidex (11.94 +/- 1.04 MPa) and Artglass (10.04 +/- 0.75 MPa). Optical analysis of the fractured surf aces indicated that for Targis and Noritake EX-3 all failures were a mixture of both cohesive and adhesive patterns. As for Artglass and Solidex, the fractures were mainly adhesive in nature.Conclusions. The Solidex system was equivalent to the Targis system in bond strength and exhibited greater strength than the Artglass system. The porcelain fused-to-metal showed considerably higher shear bond strength than the three metal-resin bonding techniques. (C) 2003 Elsevier B.V. Ltd. Ali rights reserved.

Evaluation of different rhodium modifiers and coatings on the simultaneous determination of As, Bi, Pb, Sb, Se and of Co, Cr, Cu, Fe, Mn in milk by electrothermal atomic absorption spectrometry

Different kinds of modifiers and coatings on the integrated platform of transversely heated graphite atomizer (THGA) have been tested for the simultaneous determination of two group of elements: the first, the more volatile, formed by arsenic, bismuth, lead, antimony and selenium; the second, the less volatile, formed by cobalt, chromium, cupper, iron and manganese in milk by electrothermal atomic absorption spectrometry. Different Rh-modifiers were studied, such as Rh-coated platforms (Rh), carbide plus rhodium coated platforms (W-Rh, Zr-Rh), carbide-coated platforms (W and Zr) with co-injection of RhCl3, solutions and uncoated platforms with injection of solutions of Pd(NO3)(2), Mg(NO3)(2), and RhCl3. Milk samples were diluted 1:10 in 1.0% HNO3 and injected into the tube. The mass of modifier deposited and co-injected in the tube and the use of end capped tubes were also evaluated in order to improve the electrothermal behavior of analytes. Integrated platform pretreated with W plus co-injection RhCl3 for first group and pretreated with W-Rh for second group were elected. For 20 mu L injected samples the analytical curves in the 5.0-20.0 mu g L-1 concentration range have good linear correlation coefficients (r > 0.998). Relative standard deviations (n = 12) are < 6% and the calculated characteristic masses are between 5 pg and 62 pg.

Estudo comaprativo da resistência da união esmalt/resina/metal. Efeito de resinas de fixação, artifícios retentivos e ligas metálicas.

The purpose of this study was to compare the enamel/resin/metal bond tensile strength by using human canines, in which castings were bonded. These castings were obtained by Co-Cr or Ni-Cr alloys and showed four types of mechanisms of retention: 50 micrograms aluminum oxide abrasive, electrochemical etch, acrylic beads metal mesh. The castings were bonded utilizing Comspan Opaque and Panavia Ex. The specimens were subjected to tensile forces after 24 hours in an Instron machine. The castings subjected to 50 micrograms aluminum oxide abrasive and bonded utilizing Panavia EX showed the biggest bond tensile strength.

Method for marginal measurements of restorations: accessory device for toolmakers microscope.

Standardization of measurements for marginal fit of castings is critical. This study describes the fabrication of a device that allowed fixation of specimens on a Toolmakers microscope with identical conditions according to tri-dimensional positioning of specimens, measuring location, and seating force. The device also allows mapping of the marginal discrepancies on the entire marginal perimeter of the tooth preparation.

Effect of axial loads on implant-supported partial fixed prostheses by strain gauge analysis

Objectives: The present study used strain gauge analysis to perform an in vitro evaluation of the effect of axial loading on 3 elements of implant-supported partial fixed prostheses, varying the type of prosthetic cylinder and the loading points. Material and methods: Three internal hexagon implants were linearly embedded in a polyurethane block. Microunit abutments were connected to the implants applying a torque of 20 Ncm, and prefabricated Co-Cr cylinders and plastic prosthetic cylinders were screwed onto the abutments, which received standard patterns cast in Co-Cr alloy (n = 5). Four strain gauges (SG) were bonded onto the surface of the block tangentially to the implants, SG 01 mesially to implant 1, SG 02 and SG 03 mesially and distally to implant 2, respectively, and SG 04 distally to implant 3. Each metallic structure was screwed onto the abutments with a 10 Ncm torque and an axial load of 30 kg was applied at five predetermined points (A, B, C, D, E). The data obtained from the strain gauge analyses were analyzed statistically by RM ANOVA and Tukey's test, with a level of significance of p<0.05. Results: There was a significant difference for the loading point (p=0.0001), with point B generating the smallest microdeformation (239.49 με) and point D the highest (442.77 με). No significant difference was found for the cylinder type (p=0.748). Conclusions: It was concluded that the type of cylinder did not affect in the magnitude of microdeformation, but the axial loading location influenced this magnitude.

Estudo da influência do resfriamento em revestimento de liga Stellite 6 aplicada pelo processo TIG

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito dos elementos intersticiais nas propriedades anelásticas da liga Ti-35Nb-7Zr-5Ta para aplicações biomédicas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação, por extensometria, da deformação superficial no substrato de retenção dos implantes gerada por próteses fixas implanto suportadas em função do cantilever

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)