Histological analysis of the osseointegration of Ti-30Ta dental implants after surface treatment

Metallic biomaterials are used to reinforce or to restore the form and function of hard tissues. Implants and prosthesis are used to replace shoulders, knees, hips and teeth. When these materials are inserted in bone several biological reactions happen. This process can be associated to surface properties (topography, roughness and surface energy). In this work, the influence of biomimetic surface treatment in the osseointegration of Ti-30Ta dental implants was evaluated. Ingots were obtained from titanium and tantalum by using an arc-melting furnace. They were submitted to heat treatment at 1,100°C for 1 h, cooled in water and cold worked by swaging. Then, screw-shaped implants (2.0 mm diameter by 2.5 mm length) were manufactured and they were implanted in a rat's femur. Animals were divided into two groups: untreated (control group) and treated (biomimetic surface treatment). They were sacrificed 30 days after implantation. For histological analysis, implants with surrounding tissue were removed and immersed in formaldehyde. Samples were embedded in polymethyl methacrylate and after polymerization, cut with a saw, polished and mounted on glass slides. The results obtained suggest that biomimetic surface treatment was able to promote an increase osseointegration on the surface of dental implants. © Springer-Verlag Berlin Heidelberg 2013.

Carbon nanotube-reinforced siloxane-PMMA hybrid coatings with high corrosion resistance

Siloxane-polymethyl methacrylate hybrid films containing functionalized multiwall carbon nanotubes (CNTs) were deposited by dip-coating on carbon steel substrates from a sol prepared by radical polymerization of methyl methacrylate and 3-methacryloxy propyl-trimethoxysilane, followed by hydrolytic co-polycondensation of tetraethoxysilane. The correlation between the structural properties and corrosion protection efficiency was studied as a function of the molar ratio of nanotubes carbon to silicon, varied in the range between 0.1% and 5%. 29Si nuclear magnetic resonance and thermogravimetric measurements have shown that hybrids containing carbon nanotubes have a similar degree of polycondensation and thermal stability as the undoped matrix and exhibit and excellent adhesion to the substrate. Microscopy and X-ray photoelectron spectroscopy results revealed a very good dispersion of carbon nanotubes in the hybrid matrix and the presence of carboxylic groups allowing covalent bonding with the end-siloxane nodes. Potentiodynamic polarization curves and electrochemical impedance spectroscopy results demonstrate that CNTs containing coatings maintain the excellent corrosion protection efficiency of the hybrids, showing even a superior performance in acidic solution. The nanocomposite structure acts as efficient corrosion barrier, increasing the total impedance by 4 orders of magnitude and reducing the current densities by more than 3 orders of magnitude, compared to the bare steel electrode. © 2013 Elsevier B.V. All rights reserved.

Avaliação in vitro da citotoxicidade de resinas acrílicas para reembasamento baseadas em uma nova formulação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Adição de nanopartículas de prata ao Poli (metil metacrilato): análise microbiológica

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

Resistência mecânica e alterações radiográficas na distração e estabilização intervertebral usando plug de poliuretana de mamona ou polimetilmetacrilato

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da eficácia de primers para metal na resistência ao cisalhamento da união entre cimentos resinosos e metais não nobres. Efeito do armazenamento em água

O sucesso das restaurações metálicas indiretas depende, dentre outros fatores, de uma união eficaz entre a estrutura metálica e o cimento dentário empregados. Sabe-se que os primers para metal atuam com comprovada eficácia na resistência adesiva dos cimentos resinosos às ligas nobres. Entretanto, pouco foi estudado sobre o efeito de tais materiais em ligas não nobres. O propósito deste estudo foi avaliar a eficácia de primers para metal na resistência ao cisalhamento da união entre cimentos resinosos e metais não nobres. Discos (9 mm de diâmetro e 3 mm de altura) foram fundidos em liga de NiCr (n=80) e em titânio comercialmente puro (Ti c.p.) (n=80) e foram incluídos em anel de PVC com resina acrílica quimicamente ativada. As superfícies dos discos foram regularizadas com lixas de carbeto de silício de granulação 320, 400 e 600 e jateadas com partículas de óxido de alumínio de 50 µm. Espécimes de cada metal foram divididos em quatro grupos (n=20). Uma matriz metálica bi-partida (5 mm de diâmetro interno e 2 mm de altura) foi posicionada na superfície do espécime. As áreas adesivas receberam um dos seguintes tratamentos: 1) Panavia F; 2) Alloy Primer e Panavia F; 3) Bistite DC e 4) Metaltite e Bistite DC. Para evitar a exposição dos cimentos à luz, estes foram espatulados e inseridos na matriz dentro de uma câmara de revelação radiográfica. Quarenta minutos após a confecção, os espécimes foram armazenados em água destilada a 37ºC por 24 horas e então termociclados (1.000 ciclos, 5ºC e 55ºC, 30 segundos cada banho). Após a termociclagem, os espécimes foram armazenados novamente nas mesmas condições descritas anteriormente por um período de 24 horas (n=10) ou de 6 meses (n=10) antes do ensaio de cisalhamento em uma máquina de ensaios mecânicos (Material Test System 810).

Análise por computação gráfica das alterações produzidas em próteses totais superiores imersas diretamente em água e pela termociclagem

Objectives: This study aimed to assess dimensional changes in acrylic resin base and artificial teeth position after water storage and thermocycling using computer graphics measurements. Methods: Twenty-four waxed replicas were obtained from a previous upper complete denture. For linear measurements, points in cusps tips of left central incisor and second premolars and molars were marked in one of the prostheses with graphite and transferred to the others using an acrylic resin guide. The prostheses were scanned after waxing, polymerization and treatments and the images were exported to “AutoCad 2002 Today®” software for measurements. Results: There was no statistically significant difference in changes of each segment for each group and between the phases evaluated after polymerization and thermocycling. In groups I and III, the values after polymerization are higher than those after treatment, which suggests shrinkage while the prostheses in group II have expanded. Conclusion: The three groups exhibited artificial teeth movement after tests in comparison to the polymerized prosthesis. The prostheses submitted to water storage in kiln at 36ºC during seven days showed different behavior than the other groups.

Effect of polymerization techniques and cleaning solution on flexural resistance of acrylic resin chemically activated

The purpose of this study was to evaluate the impact of different disinfection solutions on flexural resistance of chemically-activated acrylic resin. Test pieces were made of clear acrylic resin using a rectangular mold and employing two techniques: wet polymerization under pressure (n = 20) and dry polymerization under pressure (n = 20). Test pieces were subdivided into four equal groups: distilled water (control), sodium bicarbonate, 1% sodium hypochlorite and effervescent ats. The 30-day cycling technique consisted of immersing the test pieces in 100 ml of solution for 10 min three times a day and placing them in closed containers containing artificial saliva at 37°C. Subsequently, the flexural resistance of samples was tested. Data were analyzed using two-way analysis of variance (ANOVA) with forces serving as the dependent variables and the polymerization technique and cleaning agents as independent variables. Post hoc multiple comparisons were performed using Tukey’s test. There was no statistically significant difference in the flexural strength between the two polymerization techniques. The greatest flexural strength was observed for the effervescent tablets group followed by the control and 1% sodium hypochlorite groups which were statistically similar. Thus, the sodium bicarbonate solution caused the lowest flexural resistance of the test pieces.

Ceramic Primer Heat-Treatment Effect on Resin Cement/Y-TZP Bond Strength

The purpose of this study was to evaluate the effect of different heat-treatment strategies for a ceramic primer on the shear bond strength of a 10-methacryloyloxydecyl-dihydrogen-phosphate (MDP)-based resin cement to a yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Specimens measuring 4.5 x 3.5 x 4.5 mm(3) were produced from Y-TZP presintered cubes and embedded in polymethyl methacrylate (PMMA). Following finishing, the specimens were cleaned using an ultrasound device and distilled water and randomly divided into 10 experimental groups (n=14) according to the heat treatment of the ceramic primer and aging condition. The strategies used for the experimental groups were: GC (control), without primer; G20, primer application at ambient temperature (20 degrees C); G45, primer application + heat treatment at 45 degrees C; G79, primer application + heat treatment at 79 degrees C; and G100, primer application + heat treatment at 100 degrees C. The specimens from the aging groups were submitted to thermal cycling (6000 cycles, 5 degrees C/55 degrees C, 30 seconds per bath) after 24 hours. A cylinder of MDP-based resin cement (2.4 mm in diameter) was constructed on the ceramic surface of the specimens of each experimental group and stored for 24 hours at 37 degrees C. The specimens were submitted to a shear bond strength test (n=14). Thermal gravimetric analysis was performed on the ceramic primer. The data obtained were statistically analyzed by two-way analysis of variance and the Tukey test (alpha=0.05). The experimental group G79 without aging (7.23 +/- 2.87 MPa) presented a significantly higher mean than the other experimental groups without aging (GC: 2.81 +/- 1.5 MPa; G20: 3.38 +/- 2.21 MPa; G100: 3.96 +/- 1.57 MPa), showing no difference from G45 only (G45: 6 +/- 3.63 MPa). All specimens of the aging groups debonded during thermocycling and were considered to present zero bond strength for the statistical analyses. In conclusion, heat treatment of the metal/zirconia primer improved bond strength under the initial condition but did not promote stable bonding under the aging condition.

Intraoperative Patient-Specific Reconstruction of Partial Bone Flap Defects After Convexity Meningioma Resection

OBJECTIVE: To evaluate implant accuracy and cosmetic outcome of a new intraoperative patient-specific cranioplasty method after convexity meningioma resection. METHODS: The patient's own bone flap served as a template to mold a negative form with the use of polymethyl methacrylate (PMMA). The area of bone invasion was determined and broadly excised under white light illumination with a safety margin of at least 1 cm. The definitive replica was cast within the remaining bone flap frame and the imprint. Clinical and radiologic follow-up examinations were performed 3 months after surgery. RESULTS: Four women and two men (mean age 51.4 years ± 12.8) underwent reconstruction of bone flap defects after meningioma resection. Mean duration of intraoperative reconstruction of the partial bone flap defects was 19 minutes ± 4 (range 14-24 minutes). Implant sizes ranged from 17-35 cm(2) (mean size 22 cm(2) ± 8). Radiologic and clinical follow-up examinations revealed excellent implant alignment and favorable cosmesis (visual analogue scale for cosmesis [VASC] = 97 ± 5) in all patients. CONCLUSIONS: Patient-specific reconstruction of partial bone flap defects after convexity meningioma resection using the presented intraoperative PMMA cast method resulted in excellent bony alignment and a favorable cosmetic outcome. Relatively low costs and minimized operation time for adjustment and insertion of the cranioplasty implant justify use of this method in small bony defects as well.

Intraoperative template-molded bone flap reconstruction for patient-specific cranioplasty

Cranioplasty is a common neurosurgical procedure. Free-hand molding of polymethyl methacrylate (PMMA) cement into complex three-dimensional shapes is often time-consuming and may result in disappointing cosmetic outcomes. Computer-assisted patient-specific implants address these disadvantages but are associated with long production times and high costs. In this study, we evaluated the clinical, radiological, and cosmetic outcomes of a time-saving and inexpensive intraoperative method to mold custom-made implants for immediate single-stage or delayed cranioplasty. Data were collected from patients in whom cranioplasty became necessary after removal of bone flaps affected by intracranial infection, tumor invasion, or trauma. A PMMA replica was cast between a negative form of the patient's own bone flap and the original bone flap with exactly the same shape, thickness, and dimensions. Clinical and radiological follow-up was performed 2 months post-surgery. Patient satisfaction (Odom criteria) and cosmesis (visual analogue scale for cosmesis) were evaluated 1 to 3 years after cranioplasty. Twenty-seven patients underwent intraoperative template-molded patient-specific cranioplasty with PMMA. The indications for cranioplasty included bone flap infection (56%, n = 15), calvarian tumor resection (37%, n = 10), and defect after trauma (7%, n = 2). The mean duration of the molding procedure was 19 ± 7 min. Excellent radiological implant alignment was achieved in 94% of the cases. All (n = 23) but one patient rated the cosmetic outcome (mean 1.4 years after cranioplasty) as excellent (70%, n = 16) or good (26%, n = 6). Intraoperative cast-molded reconstructive cranioplasty is a feasible, accurate, fast, and cost-efficient technique that results in excellent cosmetic outcomes, even with large and complex skull defects.

Cost-effective patient-specific intraoperative molded cranioplasty

Intraoperative molding of polymethyl-methacrylate into complex three-dimensional shapes with correct thickness is often a time-consuming process and may lead to unsatisfying cosmetical results. This article describes an intraoperative technique to assemble a polymethyl-methacrylate implant as a replica of the patient's bone flap. This approach provides a fast and inexpensive alternative technique with good cosmetic outcome. The technique is feasible and can be applied in early and delayed cranioplasty procedures. In selected patients, immediate single-stage reconstruction avoids a second operation.

Patient exposure and image quality of low-dose pulmonary computed tomography angiography: comparison of 100- and 80-kVp protocols

OBJECTIVE: Measures to reduce radiation exposure and injected iodine mass are becoming more important with the widespread and often repetitive use of pulmonary CT angiography (CTA) in patients with suspected pulmonary embolism. In this retrospective study, we analyzed the capability of 2 low-kilovoltage CTA-protocols to achieve these goals. MATERIALS AND METHODS: Ninety patients weighing less than 100 kg were examined by a pulmonary CTA protocol using either 100 kVp (group A) or 80 kVp (group B). Volume and flow rate of contrast medium were reduced in group B (75 mL at 3 mL/s) compared with group A (100 mL at 4 mL/s). Attenuation was measured in the central and peripheral pulmonary arteries, and the contrast-to-noise ratios (CNR) were calculated. Entrance skin dose was estimated by measuring the surface dose in an ovoid-cylindrical polymethyl methacrylate chest phantom with 2 various dimensions corresponding to the range of chest diameters in our patients. Quantitative image parameters, estimated effective dose, and skin dose in both groups were compared by the t test. Arterial enhancement, noise, and overall quality were independently assessed by 3 radiologists, and results were compared between the groups using nonparametric tests. RESULTS: Mean attenuation in the pulmonary arteries in group B (427.6 +/- 116 HU) was significantly higher than in group A (342.1 +/- 87.7 HU; P < 0.001), whereas CNR showed no difference (group A, 20.6 +/- 7.3 and group B, 22.2 +/- 7.1; P = 0.302). Effective dose was lower by more than 40% with 80 kVp (1.68 +/- 0.23 mSv) compared with 100 kVp (2.87 +/- 0.88 mSv) (P < 0.001). Surface dose was significantly lower at 80 kVp compared with 100 kVp at both phantom dimensions (2.75 vs. 3.22 mGy; P = 0.027 and 2.22 vs. 2.73 mGy; P = 0.005, respectively). Image quality did not differ significantly between the groups (P = 0.151). CONCLUSIONS: Using 80 kVp in pulmonary CTA permits reduced patient exposure by 40% and CM volume by 25% compared with 100 kVp without deterioration of image quality in patients weighing less than 100 kg.

Augmentation of mechanical properties in osteoporotic vertebral bones--a biomechanical investigation of vertebroplasty efficacy with different bone cements

Recent clinical trials have reported favorable early results for transpedicular vertebral cement reinforcement of osteoporotic vertebral insufficiencies. There is, however, a lack of basic data on the application, safety and biomechanical efficacy of materials such as polymethyl-methacrylate (PMMA) and calciumphospate (CaP) cements. The present study analyzed 33 vertebral pairs from five human cadaver spines. Thirty-nine vertebrae were osteoporotic (bone mineral density < 0.75 g/cm2), 27 showed nearly normal values. The cranial vertebra of each pair was augmented with either PMMA (Palacos E-Flow) or experimental brushite cement (EBC), with the caudal vertebra as a control. PMMA and EBC were easy to inject, and vertebral fillings of 20-50% were achieved. The maximal possible filling was inversely correlated to the bone mineral density (BMD) values. Cement extrusion into the spinal canal was observed in 12% of cases. All specimens were subjected to axial compression tests in a displacement-controlled mode. From load-displacement curves, the stiffness, S, and the maximal force before failure, Fmax, were determined. Compared with the native control vertebrae, a statistically significant increase in vertebral stiffness and Fmax was observed by the augmentation. With PMMA the stiffness increased by 174% (P = 0.018) and Fmax by 195% (P = 0.001); the corresponding augmentation with EBC was 120% (P = 0.03) and 113% (P = 0.002). The lower the initial BMD, the more pronounced was the augmentation effect. Both PMMA and EBC augmentation reliably and significantly raised the stiffness and maximal tolerable force until failure in osteoporotic vertebral bodies. In non-porotic specimens, no significant increase was achieved.

Mechanics of cellular adhesion to artificial artery templates

We are using polymer templates to grow artificial artery grafts in vivo for the replacement of diseased blood vessels. We have previously shown that adhesion of macrophages to the template starts the graft formation. We present a study of the mechanics of macrophage adhesion to these templates on a single cell and single bond level with optical tweezers. For whole cells, in vitro cell adhesion densities decreased significantly from polymer templates polyethylene to silicone to Tygon (167, 135, and 65 cells/mm(2)). These cell densities were correlated with the graft formation success rate (50%, 25%, and 0%). Single-bond rupture forces at a loading rate of 450 pN/s were quantified by adhesion of trapped 2-mm spheres to macrophages. Rupture force distributions were dominated by nonspecific adhesion (forces, < 40 pN). On polystyrene, preadsorption of fibronectin or presence of serum proteins in the cell medium significantly enhanced adhesion strength from a mean rupture force of 20 pN to 28 pN or 33 pN, respectively. The enhancement of adhesion by fibronectin and serum is additive (mean rupture force of 43 pN). The fraction of specific binding forces in the presence of serum was similar for polystyrene and polymethyl-methacrylate, but specific binding forces were not observed for silica. Again, we found correlation to in vivo experiments, where the density of adherent cells is higher on polystyrene than on silica templates, and can be further enhanced by fibronectin adsorption. These findings show that in vitro adhesion testing can be used for template optimization and to substitute for in-vivo experiments.