Association of titanium mesh and bovine pericardium membrane in the treatment of severe enophthalmos

The blowout fractures may be classified as pure or impure depending on the associated structures. There are 2 main theories attempting to describe the mechanism of injury, the hydraulic, and blocking mechanism. The complications of this type of fracture may involve diplopia, enophthalmos, and ocular movement restriction. Several materials are available for the reconstruction of orbital floor, including the titanium mesh, which present great properties, such as easy modeling and stabilization, small thickness, and shape maintenance. There, however, are disadvantages such as the possibility of adherence formation. The aim of this report is to describe the case of a patient with an 8-month blowout fracture sequel, presenting extensive enophthalmos and treated by affixing a titanium mesh associated with bovine pericardium membrane in the orbital floor. Therefore, based on a 2-year follow-up, it was possible to observe how effective the association between these 2 materials in solving the case was.

Do oral biofilms influence the wear and corrosion behavior of titanium?

The main aim of this work was to study the simultaneous wear-corrosion of titanium (Ti) in the presence of biofilms composed of Streptococcus mutans and Candida albicans. Both organisms were separately grown in specific growth media, and then mixed in a medium supplemented with a high sucrose concentration. Corrosion and tribocorrosion tests were performed after 48 h and 216 h of biofilm growth. Electrochemical corrosion tests indicated a decrease in the corrosion resistance of Ti in the presence of the biofilms although the TiO2 film presented the characteristics of a compact oxide film. While the open circuit potential of Ti indicated a tendency to corrosion in the presence of the biofilms, tribocorrosion tests revealed a low friction on biofilm covered Ti. The properties of the biofilms were similar to those of the lubricant agents used to decrease the wear rate of materials. However, the pH-lowering promoted by microbial species, can lead to corrosion of Ti-based oral rehabilitation systems.

Influence of titanium and lutetium on the persistent luminescence of ZrO2

Non-doped as well as titanium and lutetium doped zirconia (ZrO2) materials were synthesized via the sol-gel method and structurally characterized with X-ray powder diffraction. The addition of Ti in the zirconia lattice does not change the crystalline structure whilst the Lu doping introduces a small fraction of the tetragonal phase. The UV excitation results in a bright white-blue luminescence at ca. 500 nm for all the materials which emission could be assigned to the Ti3+ e(g) -> t(2g) transition. The persistent luminescence originates from the same Ti3+ center. The thermoluminescence data shows a well-defined though rather similar defect structures for all the zirconia materials. The kinetics of persistent luminescence was probed with the isothermal decay curve analyses which indicated significant retrapping. The short duration of persistent luminescence was attributed to the quasi-continuum distribution of the traps and to the possibility of shallow traps even below the room temperature. (C) 2012 Optical Society of America

Microstructure of epitaxial thin films of the ferromagnetic shape memory alloy Ni 2 MnGa

Gegenstand dieser Arbeit ist die Präparation und die ausführliche Charakterisierung epitaktischer Dünnschicht-Proben der Heusler Verbindung Ni2MnGa. Diese intermetallische Verbindung zeigt einen magnetischen Formgedächtnis-Effekt (MFG), der sowohl im Bezug auf mögliche Anwendungen, als auch im Kontext der Grundlagenforschung äußerst interessant ist. In Einkristallen nahe der Stöchiometrie Ni2MnGa wurden riesige magnetfeldinduzierte Dehnungen von bis zu 10 % nachgewiesen. Der zugrundeliegende Mechanismus basiert auf einer Umverteilung von kristallographischen Zwillings-Varianten, die eine tetragonale oder orthorhombische Symmetrie besitzen. Unter dem Einfluss des Magnetfeldes bewegen sich die Zwillingsgrenzen durch den Kristall, was eine makroskopische Formänderung mit sich bringt. Die somit erzeugten reversiblen Längenänderungen können mit hoher Frequenz geschaltet werden, was Ni2MnGa zu einem vielversprechenden Aktuatorwerkstoff macht. rnDa der Effekt auf einem intrinsischen Prozess beruht, eignen sich Bauteile aus MFG Legierungen zur Integration in Mikrosystemen (z.B. im Bereich der Mikrofluidik). rnrnBislang konnten große magnetfeldinduzierte Dehnungen nur für Einkristalle und Polykristalle mit hoher Porosität („foams") nachgewiesen werden. Um den Effekt für Anwendungen nutzbar zu machen, werden allerdings Konzepte zur Miniaturisierung benötigt. Eine Möglichkeit bieten epitaktische dünne Filme, die im Rahmen dieser Arbeit hergestellt und untersucht werden sollen. Im Fokus stehen dabei die Optimierung der Herstellungsparameter, sowie die Präparation von freitragenden Schichten. Zudem werden verschiedene Konzepte zur Herstellung freistehender Mikrostrukturen erprobt. Mittels Röntgendiffraktometrie konnte die komplizierte Kristallstruktur für verschiedene Wachstumsrichtungen verstanden und die genaue Verteilung der Zwillingsvarianten aufgedeckt werden. In Verbindung mit Mikroskopie-Methoden konnte so die Zwillingsstruktur auf verschiedenen Längenskalen geklärt werden. Die Ergebnisse erklären das Ausbleiben des MFG Effekts in den Proben mit (100) Orientierung. Andererseits wurde für Schichten mit (110) Wachstum eine vielversprechende Mikrostruktur entdeckt, die einen guten Ausgangspunkt für weitere Untersuchungen bietet.rnDurch die spezielle Geometrie der Proben war es möglich, Spektroskopie-Experimente in Transmission durchzuführen. Die Ergebnisse stellen den ersten experimentellen Nachweis der Änderungen in der elektronischen Struktur einer metallischen Verbindung während des martensitischen Phasenübergangs dar. Durch Messen des magnetischen Zirkulardichroismus in der Röntgenabsorption konnten quantitative Aussagen über die magnetischen Momente von Ni und Mn getroffen werden. Die Methode erlaubt überdies die Beiträge von Spin- und Bahn-Moment separat zu bestimmen. Durch winkelabhängige Messungen gelang es, die mikroskopische Ursache der magnetischen Anisotropie aufzuklären. Diese Ergebnisse tragen wesentlich zum Verständnis der komplexen magnetischen und strukturellen Eigenschaften von Ni2MnGa bei.rn

Randomised comparison of titanium-nitride-oxide coated stents with bare metal stents: five year follow-up of the TiNOX trial

Revascularisation with Titanium-Nitride-Oxide (TiNOX) coated stents is safe and effective in patients with de novo native coronary artery lesions. In the TiNOX trial there was a reduction in restenosis and major adverse cardiac events as compared with stainless steel stents of otherwise identical design. The purpose of the present study was to evaluate the long-term outcome of these patients over five years.

Comparison of titanium-nitride-oxide-coated stents with zotarolimus-eluting stents for coronary revascularization a randomized controlled trial

Objectives This study sought to compare the efficacy of passive stent coating with titanium-nitride-oxide (TiNO) with drug-eluting stents releasing zotarolimus (ZES) (Endeavor, Medtronic, Minneapolis, Minnesota). Background Stent coating with TiNO has been shown to reduce restenosis compared with bare-metal stents in experimental and clinical studies. Methods In an assessor-blind noninferiority study, 302 patients undergoing percutaneous coronary intervention were randomized to treatment with TiNO or ZES. The primary endpoint was in-stent late loss at 6 to 8 months, and analysis was by intention to treat. Results Both groups were well balanced with respect to baseline clinical and angiographic characteristics. The TiNO group failed to reach the pre-specified noninferiority margin for the primary endpoint (in-stent late loss: 0.64 ± 0.61 mm vs. 0.47 ± 0.48 mm, difference: 0.16, upper 1-sided 95% confidence interval [CI]: 0.26; pnoninferiority = 0.54), and subsequent superiority testing was in favor of ZES (psuperiority = 0.02). In-segment binary restenosis was lower with ZES (11.1%) than with TiNO (20.5%; psuperiority = 0.04). A stratified analysis of the primary endpoint found particularly pronounced differences between stents among diabetic versus nondiabetic patients (0.90 ± 0.69 mm vs. 0.39 ± 0.38 mm; pinteraction = 0.04). Clinical outcomes showed a similar rate of death (0.7% vs. 0.7%; p = 1.00), myocardial infarction (5.3% vs. 6.7%; p = 0.60), and major adverse cardiac events (21.1% vs. 18.0%, hazard ratio: 1.19, 95% CI: 0.71 to 2.00; p = 0.50) at 1 year. There were no differences in rates of definite or probable stent thrombosis (0.7% vs. 0%; p = 0.51) at 1 year. Conclusions Compared with TiNO, ZES was superior with regard to late loss and binary restenosis. The concept of passive stent coating with TiNO remains inferior to drug-eluting stent technology in reducing restenosis. ([TIDE] Randomized Trial Comparing Titan Stent With Zotarolimus-Eluting Stent: NCT00492908)

Clinical long-term outcome after implantation of titanium nitride-oxide coated stents compared with paclitaxel- or sirolimus-eluting stents: propensity-score matched analysis

We performed a propensity score matched analysis to explore whether TiNOX stents are superior to paclitaxel- (PES) and sirolimus-eluting stents (SES) in routine clinical practice.

A pilot study to evaluate the success and survival rate of titanium-zirconium implants in partially edentulous patients: results after 24 months of follow-up

Implants made from a new titanium-zirconium (TiZr) alloy (Roxolid) have shown good osseointegration with no adverse effects in animal studies. This single-cohort pilot study was performed to evaluate the performance and safe use of reduced-diameter implants made from this new TiZr alloy for the first time in human subjects, in a prospective case-controlled series.

A Double-Blind Randomized Controlled Trial (RCT) of Titanium-13Zirconium versus Titanium Grade IV Small-Diameter Bone Level Implants in Edentulous Mandibles - Results from a 1-Year Observation Period

Background: The use of endosseous dental implants has become common practice for the rehabilitation of edentulous patients, and a two-implant overdenture has been recommended as the standard of care. The use of small-diameter implants may extend treatment options and reduce the necessity for bone augmentation. However, the mechanical strength of titanium is limited, so titanium alloys with greater tensile and fatigue strength may be preferable. Purpose: This randomized, controlled, double-blind, multicenter study investigated in a split-mouth model whether small-diameter implants made from Titanium-13Zirconium alloy (TiZr, Roxolid™) perform at least as well as Titanium Grade IV implants. Methods and Materials: Patients with an edentulous mandible received one TiZr and one Ti Grade IV small-diameter bone level implant (3.3 mm, SLActive®) in the interforaminal region. The site distribution was randomized and double-blinded. Outcome measures included change in radiological peri-implant bone level from surgery to 12 months post-insertion (primary), implant survival, success, soft tissue conditions, and safety (secondary). Results: Of 91 treated patients, 87 were available for the 12-month follow-up. Peri-implant bone level change (-0.3 ± 0.5 mm vs -0.3 ± 0.6 mm), plaque, and sulcus bleeding indices were not significantly different between TiZr and Ti Grade IV implants. Implant survival rates were 98.9 percent and 97.8 percent, success rates were 96.6 percent and 94.4 percent, respectively. Nineteen minor and no serious adverse events were related to the study devices. Conclusion: This study confirms that TiZr small-diameter bone level implants provide at least the same outcomes after 12 months as Ti Grade IV bone level implants. The improved mechanical properties of TiZr implants may extend implant therapy to more challenging clinical situations.

Immediate bacterial colonization of titanium implants

Background: The information on bacterial colonization immediately after dental implant insertion is limited. Aims: (1) to assess the early colonization on titanium implants immediately post placement through the first12 post-surgical weeks , (2) to compare the microflora at interproximal subgingival implant and adjacent tooth sites. Material and Methods: Subgingival plaque samples from implant and neighbouring teeth were studied by checkerboard DNA-DNA hybridization before, 30 min. after implant placement , 1 week, 2 weeks, 4 weeks, 8 weeks, and 12 weerks after surgery. Results: Comparing bacterial loads at implant sites between 30 min. after placement with one week data showed that only the levels of V.parvula (p<0.05) differed with higher loads at week 1. Week 12 data demonstrated significantly higher bacterial loads for 15/40 species at tooth sites compared to pre-surgery (p < values varying between 0.05 and 0.01). Between immediately post-surgery and week 12 at implant sites 29/40 species were more commonly found at week 12. Included among these bacteria at implant sites were P.gingivalis (p< 0.05), T.forsythia, (p < 0.01), and T denticola (p<0.001). Immediately post-surgery 5.9% of implants, and 26.2% of teeth and at week 12, 15.0 % of implants, and 39.1% of teeth harbored S.aureus. Comparing tooth and implant sites, significantly higher bacterial loads were found at tooth sites for 27/40 species at the 30 minutes after placement interval. This difference increased to 35/40 species at week 12. Conclusions: The colonization of bacteria occurs within 30 minutes. Colonization patterns differed between implants and tooth surfaces.

Enhancement of titanium implants via bioengineered periodontal tissues

Osseointegration of titanium dental implants into the jaw bone, which is required for maintenance of the implant in the jaw, results in ankylosis. Dental implants are therefore very unlike natural teeth, which exhibit significant movement in response to mechanical forces. The ability to generate periodontal ligament (PDL) tissues onto dental implants would better mimic the functional characteristics of natural teeth, and would likely improve implant duration and function. OBJECTIVES: The objective of this study was to investigate the feasibility of bioengineering PDL tissues onto titanium implant surfaces. METHODS: Bilateral maxillary first and second molars of 8-week old rats were extracted and used to generate single cell suspensions of PDL tissues, which were expanded in culture. Immunohistochemistry and RT-PCR were used to identify putative PDL progenitor/stem cell populations and characterize stem cell properties, including self-renewal, multipotency and stem cell maker expression. Cultured rPDL cells were harvested at third passage, seeded onto Matrigel-coated titanium implants (1.75 mm x 1 mm), and placed into healed M1/M2 extraction sites. Non-cell seeded Matrigel-coated titanium implants served as negative controls. Implants were harvested after 8, 12, or 18 weeks. RESULTS: Cultured rPDL cells expressed the mesenchymal stem-cell marker STRO-1. Under defined culture conditions, PDL cells differentiated into adipogenic, neurogenic and osteogenic lineages. While control implants were largely surrounded by alveolar bone, experimental samples exhibited fibrous PDL-like tissues, and perhaps cementum, on the surface of experimental implants. CONCLUSIONS: PDL contains stem cells that can generate cementum/PDL-like tissue in vivo. Transplantation of these cells might hold promise as a therapeutic approach for the bioengineering of PDL tissues onto titanium implant. Further refinement of this method will likely result in improved dental implant strategies for use of autologous PDL tissue regeneration in humans. This research was supported by CIMIT, and NIH/NIDCR grant DE016132 (PCY), and TEACRS (YL).

Structural and surface property characterization of titanium dioxide nanotubes for orthopedic implants

This research focused on the to modification of the surface structure of titanium implants with nanostructured morphology of TiO2 nanotubes and studied the interaction of nanotubes with osteoblast cells to understand the parameters that affect the cell growth. The electrical, mechanical, and structural properties of TiO2 nanotubes were characterized to establish a better understanding on the properties of such nanoscale morphological structures. To achieve the objectives of this research work I transformed the titanium and its alloys, either in bulk sheet form, bulk machined form, or thin film deposited on another substrate into a surface of titania nanotubes using a low cost and environmentally friendly process. The process requires only a simple electrolyte, low cost electrode, and a DC power supply. With this simple approach of scalable nanofabrication, a typical result is nanotubes that are each approximately 100nm in diameter and have a wall thickness of about 20nm. By changing the fabrication parameters, independent nanotubes can be fabricated with open volume between them. Titanium in this form is termed onedimensional since electron transport is narrowly confined along the length of the nanotube. My Ph.D. accomplishments have successfully shown that osteoblast cells, the cells that are the precursors to bone, have a strong tendency to attach to the inside and outside of the titanium nanotubes onto which they are grown using their filopodia – cell’s foot used for locomotion – anchored to titanium nanotubes. In fact it was shown that the cell prefers to find many anchoring sites. These sites are critical for cell locomotion during the first several weeks of maturity and upon calcification as a strongly anchored bone cell. In addition I have shown that such a surface has a greater cell density than a smooth titanium surface. My work also developed a process that uses a focused and controllably rastered ion beam as a nano-scalpel to cut away sections of the osteoblast cells to probe the attachment beneath the main cell body. Ultimately the more rapid growth of osteoblasts, coupled with a stronger cell-surface interface, could provide cost reduction, shorter rehabilitation, and fewer follow-on surgeries due to implant loosening.