Photopolymerizable hydrogels for implants: Monte-Carlo modeling and experimental in vitro validation.

Photopolymerization is commonly used in a broad range of bioapplications, such as drug delivery, tissue engineering, and surgical implants, where liquid materials are injected and then hardened by means of illumination to create a solid polymer network. However, photopolymerization using a probe, e.g., needle guiding both the liquid and the curing illumination, has not been thoroughly investigated. We present a Monte Carlo model that takes into account the dynamic absorption and scattering parameters as well as solid-liquid boundaries of the photopolymer to yield the shape and volume of minimally invasively injected, photopolymerized hydrogels. In the first part of the article, our model is validated using a set of well-known poly(ethylene glycol) dimethacrylate hydrogels showing an excellent agreement between simulated and experimental volume-growth-rates. In the second part, in situ experimental results and simulations for photopolymerization in tissue cavities are presented. It was found that a cavity with a volume of 152  mm3 can be photopolymerized from the output of a 0.28-mm2 fiber by adding scattering lipid particles while only a volume of 38  mm3 (25%) was achieved without particles. The proposed model provides a simple and robust method to solve complex photopolymerization problems, where the dimension of the light source is much smaller than the volume of the photopolymerizable hydrogel.

Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures

Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems, where a 3D volume or surface representation of the operated anatomy could be constructed from the preoperatively acquired tomographic data or through intraoperatively digitized anatomy landmarks, a photorealistic rendering of the surgical action has been identified to greatly improve usability of these navigation systems. However, this may not hold true when the virtual representation of surgical instruments and implants is superimposed onto 2D projection images in a fluoroscopy-based navigation system due to the so-called image occlusion problem. Image occlusion occurs when the field of view of the fluoroscopic image is occupied by the virtual representation of surgical implants or instruments. In these situations, the surgeon may miss part of the image details, even if transparency and/or wire-frame rendering is used. In this paper, we propose to use non-photorealistic rendering to overcome this difficulty. Laboratory testing results on foamed plastic bones during various computer-assisted fluoroscopybased surgical procedures including total hip arthroplasty and long bone fracture reduction and osteosynthesis are shown.

Isochronal sintering of the blended elemental Ti-35Nb alloy

Titanium alloy parts are ideally suited for advanced aerospace systems and surgical implants because of their unique combination of high specific strength at both room temperature and moderately elevated temperature, in addition to excellent corrosion resistance. In this work, results of the Ti-35Nb alloy sintering are presented. This alloy, due to its lower modulus of elasticity and high biocompatibility, is a promising candidate for surgical and aerospace applications. Samples were produced by mixing of initial metallic hydride powders followed by uniaxial and cold isostatic pressing with subsequent densification by isochronal sintering between 700 and 1500 degrees C, in vacuum. Sintering behavior was studied by means of microscopy and density. Sintered samples were characterized for phase composition, microstructure and microbardness by X-ray diffraction, scanning electron microscopy and Vickers indentation, respectively. Samples sintered at high temperatures display a fine plate-like a structure and intergranular P. A few remaining pores are still found, and density above 97% for specimens sintered at 1500 degrees C is reached. (c) 2007 Elsevier B.V. All rights reserved.

Estudo comparativo entre as esferas de silicone gelatinosas e rígidas em cavidade eviscerada de coelho

Pós-graduação em Bases Gerais da Cirurgia - FMB

Biocompatibilidade in vitro em amostras densas e porosas de titânio-35nióbio submetidas a tratamento biomimético

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparação in vivo da biocompatilidade de amostras com superfície porosa confeccionadas com diferentes ligas de titânio

Pós-graduação em Biopatologia Bucal - ICT

Computational modeling of surface interactions

Die Wechselwirkung zwischen Proteinen und anorganischen Oberflächen fasziniert sowohl aus angewandter als auch theoretischer Sicht. Sie ist ein wichtiger Aspekt in vielen Anwendungen, unter anderem in chirugischen Implantaten oder Biosensoren. Sie ist außerdem ein Beispiel für theoretische Fragestellungen betreffend die Grenzfläche zwischen harter und weicher Materie. Fest steht, dass Kenntnis der beteiligten Mechanismen erforderlich ist um die Wechselwirkung zwischen Proteinen und Oberflächen zu verstehen, vorherzusagen und zu optimieren. Aktuelle Fortschritte im experimentellen Forschungsbereich ermöglichen die Untersuchung der direkten Peptid-Metall-Bindung. Dadurch ist die Erforschung der theoretischen Grundlagen weiter ins Blickfeld aktueller Forschung gerückt. Eine Möglichkeit die Wechselwirkung zwischen Proteinen und anorganischen Oberflächen zu erforschen ist durch Computersimulationen. Obwohl Simulationen von Metalloberflächen oder Proteinen als Einzelsysteme schon länger verbreitet sind, bringt die Simulation einer Kombination beider Systeme neue Schwierigkeiten mit sich. Diese zu überwinden erfordert ein Mehrskalen-Verfahren: Während Proteine als biologische Systeme ausreichend mit klassischer Molekulardynamik beschrieben werden können, bedarf die Beschreibung delokalisierter Elektronen metallischer Systeme eine quantenmechanische Formulierung. Die wichtigste Voraussetzung eines Mehrskalen-Verfahrens ist eine Übereinstimmung der Simulationen auf den verschiedenen Skalen. In dieser Arbeit wird dies durch die Verknüpfung von Simulationen alternierender Skalen erreicht. Diese Arbeit beginnt mit der Untersuchung der Thermodynamik der Benzol-Hydratation mittels klassischer Molekulardynamik. Dann wird die Wechselwirkung zwischen Wasser und den [111]-Metalloberflächen von Gold und Nickel mittels eines Multiskalen-Verfahrens modelliert. In einem weiteren Schritt wird die Adsorbtion des Benzols an Metalloberflächen in wässriger Umgebung studiert. Abschließend wird die Modellierung erweitert und auch die Aminosäuren Alanin und Phenylalanin einbezogen. Dies eröffnet die Möglichkeit realistische Protein- Metall-Systeme in Computersimulationen zu betrachten und auf theoretischer Basis die Wechselwirkung zwischen Peptiden und Oberflächen für jede Art Peptide und Oberfläche vorauszusagen.

Rehabilitation of orbital cavity after total orbital exenteration using oculofacial prostheses anchored by osseointegrated dental implants posed as a one-step surgical procedure

BACKGROUND: Total orbital exenteration is a radical surgical procedure, which typically involves the removal of the entire contents of the orbit including the periorbita, leaving the patient with a deep orbital deformity and results in devastating cosmetic, functional, and psychological consequences requiring difficult and challenging procedures for oculoplastic surgeons. Oculofacial prostheses retained by endosseous dental implants present an attractive and viable alternative when aesthetic and functional demands are beyond the capacity of local reconstructive efforts. PATIENTS AND METHODS: A 72-year-old woman presenting a malignant melanoma of the right eyelids and a 77-year-old man presenting a sebaceous carcinoma of the left upper eyelid underwent a total exenteration followed by positioning of endosseous implants (Straumann system Dental implants) as an integrated one-step combined surgical procedure. The oculofacial prosthesis was placed after epithelialization of the orbital cavity. RESULTS: The implants were perfectly osseointegrated without any complications, providing sufficient retention of the prostheses. A satisfactory aesthetic outcome has been achieved for both patients. CONCLUSIONS: Oculofacial prostheses anchored by osseointegrated dental implants placed as one-step surgical procedure ensure an adequate aesthetic result as well as a considerably decreased rehabilitation time and present a satisfactory solution when reconstruction is not a suitable option.

Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs

Aim To compare the remodeling of the alveolar process at implants installed immediately into extraction sockets by applying a flap or a ""flapless"" surgical approach in a dog model. Material and methods Implants were installed immediately into the distal alveoli of the second mandibular premolars of six Labrador dogs. In one side of the mandible, a full-thickness mucoperiosteal flap was elevated (control site), while contra-laterally, the mucosa was gently dislocated, but not elevated (test site) to disclose the alveolar crest. After 4 months of healing, the animals were sacrificed, ground sections were obtained and a histomorphometric analysis was performed. Results After 4 months of healing, all implants were integrated (n=6). Both at the test and at the control sites, bone resorption occurred with similar outcomes. The buccal bony crest resorption was 1.7 and 1.5 mm at the control and the test sites, respectively. Conclusions ""Flapless"" implant placement into extraction sockets did not result in the prevention of alveolar bone resorption and did not affect the dimensional changes of the alveolar process following tooth extraction when compared with the usual placement of implants raising mucoperiosteal flaps. To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Bressan E, Lang NP. Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 1314-1319.doi: 10.1111/j.1600-0501.2009.01959.x.

Flap vs. "flapless" surgical approach at immediate implants: a histomorphometric study in dogs

AimTo compare the remodeling of the alveolar process at implants installed immediately into extraction sockets by applying a flap or a "flapless" surgical approach in a dog model.Material and methodsImplants were installed immediately into the distal alveoli of the second mandibular premolars of six Labrador dogs. In one side of the mandible, a full-thickness mucoperiosteal flap was elevated (control site), while contra-laterally, the mucosa was gently dislocated, but not elevated (test site) to disclose the alveolar crest. After 4 months of healing, the animals were sacrificed, ground sections were obtained and a histomorphometric analysis was performed.ResultsAfter 4 months of healing, all implants were integrated (n=6). Both at the test and at the control sites, bone resorption occurred with similar outcomes. The buccal bony crest resorption was 1.7 and 1.5 mm at the control and the test sites, respectively.Conclusions"Flapless" implant placement into extraction sockets did not result in the prevention of alveolar bone resorption and did not affect the dimensional changes of the alveolar process following tooth extraction when compared with the usual placement of implants raising mucoperiosteal flaps.To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Bressan E, Lang NP. Flap vs. "flapless" surgical approach at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 1314-1319.doi: 10.1111/j.1600-0501.2009.01959.x.

Retrolabyrinthine approach for surgical placement of auditory brainstem implants in children

Conclusion: The extended retrolabyrinthine approach (RLA) is a safe and reliable approach for auditory brainstem placement in children. The surgical landmarks to reach cochlear nucleus are adequately exposed by this approach. Objective: To describe a new approach option for auditory brainstem implants (ABIs) in children, highlighting the anatomical landmarks to appropriately expose the foramen of Luschka. Methods: Three prelingually deafened children consecutively operated for ABIs via the RLA. Results: ABI placement via the RLA was successfully performed in all children without any further complications except multidirectional nystagmus in one child. The RLA we employed differed from that used for vestibular schwannoma only in the removal of the posterior semicircular canal. The lateral and superior semicircular canals and the vestibule remained intact, and there was no need to expose the dura of the internal auditory meatus. The jugular bulb was completely exposed to allow adequate visualization of the ninth cranial nerve and cerebellar flocculus.

Hearing Preservation And Cochlear Implants According To Inner Ear Approach: Multicentric Evaluation.

Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX™ EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach.

Reconstruction of bony facial contour deficiencies with polymethylmethacrylate implants: case report

Facial trauma can be considered one of the most serious aggressions found in the medical centers due to the emotional consequences and the possibility of deformity. In craniofacial surgery, the use of autologous bone is still the first choice for reconstructing bony defects or irregularities. When there is a shortage of donor bone or a patient refuses an intracranial operation, alloplastic materials such as polymethylmethacrylate (PMMA) can be used. The PMMA prosthesis can be pre-fabricated, bringing advantages such as reduction of surgical time, easy technical handling and good esthetic results. This paper describes the procedures for rehabilitating a patient with PMMA implants in the region of the face, recovering the facial contours and esthetics of the patient.