Science.gov

Sample records for peri-implant soft tissue

  1. Peri-implant soft tissue management: Where are we?

    PubMed

    Bhatavadekar, Neel

    2012-10-01

    Dental implants have evolved dramatically over the last decade, and so have our expectations from them in terms of functional and esthetic criteria. The maintenance and augmentation of the soft tissue has emerged as an area of concern and focus. The triad of anatomical peri-implant characteristics, soft tissue response to the implant material, and clinical skill form the fundamental principles in augmenting soft tissue. However, as clinicians, where are we with regards to the ability to augment and maintain soft tissue around dental implants, about 40 years after the first implants were placed? We now understand that peri-implant soft tissue management begins with extraction management. Our treatment modalities have evolved from socket compression post-extraction, to socket preservation with an aim to enhance the eventual peri-implant soft tissue. This short communication will assess the evolution of our thought regarding peri-implant soft tissue management, augmentation of keratinized mucosa around implants, and also look at some recent techniques including the rotated pedicle connective tissue graft for enhancing inter-implant papilla architecture. With newer research modalities, such as cyto-detachment technology, and cutting-edge bioengineering solutions (possibly a soft-tissue-implant construct) which might be available in the near future for enhancing soft tissue, we are certainly in an exciting era in dentistry. PMID:23493178

  2. [Research progress in peri-implant soft tissue engineering augmentation method].

    PubMed

    Pei, T T; Yu, H Q; Wen, C J; Guo, T Q; Zhou, Y M; Peng, H M

    2016-05-01

    The sufficiency of hard and soft tissue at the implant site is the guarantee of long-term function, health and the appearance of implant denture. Problem of soft tissue recession at the implant site has always been bothering dentists. Traditional methods for augmentation of soft tissue such as gingival transplantation have disadvantages of instability of the increased soft-tissue and more trauma. Lately the methods that base on tissue engineering to increase the soft tissue of peri-implant sites have drawn great attention. This review focuses on the current methods of peri-implant restoration through tissue engineering, seed cells, biological scaffolds and cytokines. PMID:27220393

  3. Do we need keratinized mucosa for a healthy peri-implant soft tissue?

    PubMed

    Esfahanizadeh, Nasrin; Daneshparvar, Niloufar; Motallebi, Sara; Akhondi, Nasrin; Askarpour, Farinaz; Davaie, Sotudeh

    2016-01-01

    The presence of keratinized mucosa plays a fundamental role in peri-implant soft tissue health. This study assessed the impact of the width of keratinized mucosa (WKM) on peri-implant soft tissue parameters. A cross-sectional study was conducted on 110 bone-level implants in 36 patients. A minimum of 6 months had passed since the loading of implants, and the patients had at least 1 implant in 1 quadrant at the molar or premolar site restored with a single crown or fixed partial denture. The health of peri-implant soft tissue was assessed with a modified bleeding index (MBI), modified plaque index (MPI), and modified gingival index (MGI). Probing depth (PD), gingival recession (GR), and WKM were also measured. History of smoking and oral hygiene methods were recorded. A significant inverse correlation existed between WKM and the parameters MBI, MPI, MGI, and GR (P < 0.05). Values of MBI, MPI, MGI, and GR were significantly lower in areas with WKM ≥ 2 mm and higher in areas with WKM < 2 mm (P < 0.05). The WKM was greatest in subjects using the vibratory toothbrushing technique and narrowest in those using the horizontal toothbrushing technique (P < 0.05). The mean WKM was significantly greater in smokers than in nonsmokers (P < 0.05). Results of this study indicate that an association exists between WKM and peri-implant soft tissue health. A minimum of 2 mm of keratinized mucosa around implants is recommended. PMID:27367634

  4. Combined Soft and Hard Tissue Peri-Implant Plastic Surgery Techniques to Enhance Implant Rehabilitation: A Case Report

    PubMed Central

    Baltacıoğlu, Esra; Korkmaz, Fatih Mehmet; Bağış, Nilsun; Aydın, Güven; Yuva, Pınar; Korkmaz, Yavuz Tolga; Bağış, Bora

    2014-01-01

    This case report presents an implant-aided prosthetic treatment in which peri-implant plastic surgery techniques were applied in combination to satisfactorily attain functional aesthetic expectations. Peri-implant plastic surgery enables the successful reconstruction and restoration of the balance between soft and hard tissues and allows the option of implant-aided fixed prosthetic rehabilitation. PMID:25489351

  5. Accurate registration of peri-implant soft tissues to create an optimal emergence profile

    PubMed Central

    Alshiddi, Ibraheem Fahad; Dent, D. Clin

    2015-01-01

    One of the challenges in restoring anterior space with implant restoration is maintaining the natural looking of peri-implant area. This case report presents a clinical procedure to create the soft tissue emergence profile for anterior maxillary teeth. A 49-year-old male presented with missing right maxillary lateral incisor. A provisional restoration was inserted 1 week after implant placement. Area of the provisional restoration related to the gingival tissue (transmucosal area) was adjusted to create an optimum emergence profile. Two months later, an indirect method was used to accurately transfer the soft peri-implant tissues to the master cast. This clinical technique minimizes surgical procedure and avoids the possibility of soft tissue collapsing that may occur during the impression procedure. PMID:25821365

  6. Platform switching and abutment emergence profile modification on peri-implant soft tissue.

    PubMed

    Dornbush, Jeffrey R; Reiser, Gary M; Ho, Daniel K

    2014-01-01

    Although the peri-implant hard tissue advantages of platform switching abutments have been well documented by many authors, the peri-implant soft tissue advantages of platform switching abutments has had limited mention. This article illustrates how the amount of peri-implant soft tissue volume is influenced by the dimensional extent of platform switching and the degree that an abutment's sulcular emergence profile has been modified. This article also introduces the term "abutment sulcular emergence profile enhancement" (ASEPE) to describe the combined effect of platform switching and abutment emergence profile modification. Three unrecognized clinical advantages of ASEPE are described by different clinical cases. First, elimination of excessive abutment impingement on gingival tissue adjacent to implants is achieved. Second, allowance for sufficient interproximal space between implant and adjacent tooth/implant for the entry of interproximal toothbrush is made possible. Third, excessive soft tissue blanching during abutment seating at prosthesis delivery is eliminated. Together, the combined application of platform switching and abutment emergence profile modification represents the opening of a new realm for managing soft tissue around implants to resolve dimensional problems. PMID:25269220

  7. Different types of inflammatory reactions in peri-implant soft tissues.

    PubMed

    Ericsson, I; Persson, L G; Berglundh, T; Marinello, C P; Lindhe, J; Klinge, B

    1995-03-01

    The aim of the present study was to analyze some features of the peri-implant mucosa at sites in the dog model which had been exposed to plaque accumulation for periods up to 9 months. The experiment was carried out in 5 labrador dogs. The mandibular right and left 2nd, 3rd and 4th premolars (2P2, 3P3, 4P4) and the 1st molars (1M1) were extracted. Following a 3-month healing period, 3 titanium fixtures (Nobelpharma AB, Göteborg, Sweden) were installed in the edentulous premolar/molar regions. Abutment connection was performed 3 months later and a meticulous plaque control period of 3 months was initiated. A clinical examination was performed at the end of this preparatory period and a main study period of 9 months continued. During this period, the plaque control regimen was maintained in the mesial and central (left: L1, 2 and right: R1, 2) implant segments, whereas plaque was allowed to accumulate on the distal implants, i.e.. L3 and R3. At the end of the main study period, i.e., 12 months after abutment connection, the clinical examination was repeated, the animals perfused and biopsies obtained. Semi-thin sections were produced for histometric and morphometric analyses. The peri-implant mucosa at implant sites exposed to daily and comprehensive plaque control at biopsy was clinically noninflamed and the connective tissue lateral to a junctional epithelium was devoid of accumulations of inflammatory cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7790533

  8. Effect of Platelet Rich Fibrin (PRF) on Peri-implant Soft Tissue and Crestal Bone in One-Stage Implant Placement: A Randomized Controlled Trial

    PubMed Central

    Boora, Priyanka; Bhoria, Mohaneesh

    2015-01-01

    Introduction The viability of Platelet Rich Fibrin (PRF) on enhancement of osseous and associated tissue healing has been substantiated well in literature. However, paucity in the applicability of PRF to enhance peri-implant healing in oral region is not well-corroborated. Purpose This prospective study evaluated the effect of Platelet PRF on peri-implant tissue response following one-stage implant placement with non-functional immediate provisionalization in maxillary anterior region. Materials and Methods A Prospective, Randomized Controlled Trial (RCT) was conducted across 20 (15 male, 5 Female) systemically healthy subjects with maintainable oral hygiene. Subjects were broadly divided into two groups i.e. Study group (PRF group) and Control group (Non-PRF group). Twenty standard SLA- AB/AE (alumina oxide blasted/acid etched surface treated) tapered threaded dental implants were randomly placed with and without PRF and immediately provisionalized. The subjects were evaluated clinically and radiographically at baseline (at time of implant placement), one month and three month post-operatively for peri-implant soft tissue and crestal bone responses. Results At 3 months, all implants remained osseointegrated. The mean marginal bone changes were observed from baseline to 3 months in both groups with lesser changes observed in PRF Group. No significant differences in probing depth and bleeding on probing were noted during follow-up. Conclusion Within the limitations of this study, PRF could be considered as a healing biomaterial with potential beneficial effect on peri-implant tissue and can be used as a therapeutic adjuvant in clinical scenario of one stage, single tooth implant placement procedure in maxillary anterior region. PMID:26023636

  9. Digital image processing. II. In vitro quantitative evaluation of soft and hard peri-implant tissue changes.

    PubMed

    Fourmousis, I; Brägger, U; Bürgin, W; Tonetti, M; Lang, N P

    1994-06-01

    The aim of this study was to evaluate the ability of computer-assisted densitometric image analysis (CADIA) to detect small changes in mineralized and nonmineralized tissues adjacent to dental implants and to correlate these changes with CADIA values. A section of a pig mandible including all soft tissues and in which a hollow cylinder ITI Bonefit implant with an artificial mesial and a buccal infrabony defect was placed was used to obtain pairs of standardized radiographs. Series of radiographs were obtained with exposure times of 0.13, 0.20, 0.44, and 0.53 s. Specimens of mineralized or nonmineralized tissues were placed arbitrarily in the defects before each radiographic exposure. The radiographs were captured through a video camera, digitized and stored in a personal computer. Every radiographic image was then subtracted from a baseline one without any change. The result of the subtraction was evaluated with CADIA. A linear correlation (r2 = 0.99) was found between the bone chips (1-5 mg of dry weight) placed in the mesial defect and the CADIA values. Bone chips in the buccal defect (behind the implant), however, were not detected unless their weight reached 14 mg or more. For conventionally exposed radiographs, it was not possible to recognize soft tissue specimens (1-6 mg), either in the buccal or the mesial defect. However, when "underexposed" radiographs (exposure time: 0.13 s) were obtained, a linear correlation (r2 = 0.80) was calculated for soft tissue specimens in the mesial defect and CADIA values. In normally exposed radiographs, the CADIA system could detect even the smallest change in bone density (bone chip of 1 mg of dry bone weight) and correlated almost linearly with these changes. Provided that the radiographic images are obtained with standardized geometry and normal exposure time, the tissue density changes detected by this system within bone defects represent only mineralized tissue changes. By underexposing radiographs, CADIA may even

  10. A Classification System for Peri-implant Diseases and Conditions.

    PubMed

    Sarmiento, Hector L; Norton, Michael R; Fiorellini, Joseph P

    2016-01-01

    Peri-implant bone levels are influenced by pathologic and nonpathologic conditions. The understanding of peri-implant disease has evolved over the past several decades, and the classification of peri-implantitis has been limited to descriptions of disease progression or those involving soft and/or hard tissues (peri-implant mucositis or peri-implantitis). However, no classification system has been established based on etiology. The objective of this study was to identify various etiologies for peri-implantitis and to establish a classification system based on the pathogenesis. The results indicate that the majority of bone loss was related to biofilm, followed by iatrogenic factors, exogenous irritants, absence of keratinized tissue, and extrinsic pathology. The proposed classification system will allow the clinician to properly diagnose peri-implant diseases in relation to etiology. These conditions may respond differently to applied therapies. PMID:27560674

  11. Group D. Initiator paper. Implants--peri-implant (hard and soft tissue) interactions in health and disease: the impact of explosion of implant manufacturers.

    PubMed

    Ivanovski, Saso

    2015-01-01

    1. The best-documented implants have a threaded solid screw-type design and are manufactured from commercially pure (grade IV) titanium. There is good evidence to support implants ≥ 6 mm in length, and ≥ 3 mm in diameter. 2. Integrity of the seal between the abutment and the implant is important for several reasons, including minimization of mechanical and biological complications and maintaining marginal bone levels. Although the ideal design features of the implant-abutment connection have not been determined, an internal connection, micro-grooves at the implant collar, and horizontal offset of the implant-abutment junction (platform switch) appear to impart favorable properties. 3. Implants with moderately rough implant surfaces provide advantages over machined surfaces in terms of the speed and extent of osseointegration. While the favorable performances of both minimally and moderately rough surfaces are supported by long-term data, moderately rough surfaces provide superior outcomes in compromised sites, such as the posterior maxilla. 4. Although plaque is critical in the progression of peri-implantitis, the disease has a multi-factorial aetiology, and may be influenced by poor integrity of the abutment/implant connection. Iatrogenic factors, such as the introduction of a foreign body. (e.g., cement) below the mucosal margin, can be important contributors. 5. Clinicians should exercise caution when using a particular implant system, ensuring that the implant design is appropriate and supported by scientific evidence. Central to this is access to and participation in quality education on the impact that implant characteristics can have on clinical outcomes. Caution should be exercised in utilizing non-genuine restorative componentry that may lead to a poor implant-abutment fit and subsequent technical and biological complications. PMID:25764593

  12. Peri-implant esthetics assessment and management

    PubMed Central

    Balasubramaniam, Aarthi S.; Raja, Sunitha V.; Thomas, Libby John

    2013-01-01

    Providing an esthetic restoration in the anterior region of the mouth has been the basis of peri-implant esthetics. To achieve optimal esthetics, in implant supported restorations, various patient and tooth related factors have to be taken into consideration. Peri-implant plastic surgery has been adopted to improve the soft tissue and hard tissue profiles, during and after implant placement. The various factors and the procedures related to enhancement of peri-implant esthetics have been discussed in this review article. PMID:23878557

  13. Evaluation of peri-implant soft tissue and bone levels around early loaded implant in restoring single missing tooth: A clinico-radiographic study

    PubMed Central

    Bhardwaj, Isha; Bhushan, Anoop; Baiju, Chandrababu Sudha; Bali, Shweta; Joshi, Vaibhav

    2016-01-01

    Background: One-stage nonsubmerged protocol which can achieve success rates comparable to implants placed in a two-staged submerged procedure also the preconditions for periimplant bone regeneration has lead to more refined concepts of implant loading. Materials and Methods: Twenty sites with single missing tooth were included in this study. Clinical parameters included sulcus bleeding index (sBI), probing pocket depth (PD), and papilla index (PI) and radiographic parameters included crestal bone level were assessed for a period of 9 months. Results: The crestal bone loss showed mean value ranging from baseline 0.25 ± 0.11 to 0.31 ± 0.08 at 3 weeks, to 0.67 ± 0.13 at 3 months, to 0.85 ± 0.09 at 6 months, and to 0.88 ± 0.12 at 9 months. Probing PD, the mean value for probing PD at 3 weeks 1.20 ± 0.83, 3 months 1.60 ± 1.1, at 6 months 1.40 ± 1.14, and at 9 months 1.20 ± 1.0. sBI, mean value for sBI at 3 weeks 0.00 ± 0.00, 3 months 0.3 ± 0.11, at 6 months 0.09 ± 0.25, and at 9 months 0.08 ± 0.24. PI, showed a significant difference among at different points of time with P = 0.000. Conclusion: The dental implants showed <1 mm of crestal bone loss at 9 months follow-up, clinically significant marginal bone loss occurred between the time of implant placement and 3 months. Subsequent to that, bone loss observed around the implant up to 9 months was minimal. The periimplant soft tissue maturity was maintained throughout the study. PMID:27041836

  14. Peri-implant tissue behavior around non-titanium material: Experimental study in dogs.

    PubMed

    Maté Sánchez de Val, José Eduardo; Gómez-Moreno, Gerardo; Pérez-Albacete Martínez, Carlos; Ramírez-Fernández, Maria Piedad; Granero-Marín, Jose Manuel; Gehrke, Sergio Alexandre; Calvo-Guirado, José Luis

    2016-07-01

    The aim of this study is to assess the effectiveness of using non-titanium abutments for better establishment of peri-implant biological width and to assess the stability of the soft tissue. Forty-eight tapered dental titanium implants with internal connection of 3.5mm in diameter and 10mm length were implanted in post extraction alveoli of 6 dogs. Twenty-four abutments made in a reinforced polyetheretherketone (PEEK) formed the test group, and 24 titanium abutments, the control group. The groups were randomized. Histological, histomorphometric, ISQ and radiological analyses were performed. Greatest differences (control group vs. test group) were found at PM-Lc (Mucosa to lingual bone contact) (2.91±0.03 vs. 3.71±0.18), and to PM Lingual-IS (2.65±0.43 vs. 3.57±0.38). Reinforced PEEK constitutes an effective alternative to conventional titanium abutments, given its high rate of biocompatibility, preservation of bone height and soft tissue stability. PMID:27045596

  15. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology.

    PubMed

    Lindhe, Jan; Meyle, Joerg

    2008-09-01

    Issues related to peri-implant disease were discussed. It was observed that the most common lesions that occur, i.e. peri-implant mucositis and peri-implantitis are caused by bacteria. While the lesion of peri-implant mucositis resides in the soft tissues, peri-implantitis also affects the supporting bone. Peri-implant mucositis occurs in about 80% of subjects (50% of sites) restored with implants, and peri-implantitis in between 28% and 56% of subjects (12-40% of sites). A number of risk indicators were identified including (i) poor oral hygiene, (ii) a history of periodontitis, (iii) diabetes and (iv) smoking. It was concluded that the treatment of peri-implant disease must include anti-infective measures. With respect to peri-implant mucositis, it appeared that non-surgical mechanical therapy caused the reduction in inflammation (bleeding on probing) but also that the adjunctive use of antimicrobial mouthrinses had a positive effect. It was agreed that the outcome of non-surgical treatment of peri-implantitis was unpredictable. The primary objective of surgical treatment in peri-implantitis is to get access to the implant surface for debridement and decontamination in order to achieve resolution of the inflammatory lesion. There was limited evidence that such treatment with the adjunctive use of systemic antibiotics could resolve a number of peri-implantitis lesions. There was no evidence that so-called regenerative procedures had additional beneficial effects on treatment outcome. PMID:18724855

  16. Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis.

    PubMed

    Derks, J; Schaller, D; Håkansson, J; Wennström, J L; Tomasi, C; Berglundh, T

    2016-01-01

    Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with ≥4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned ≤1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772). PMID:26701919

  17. Definition, etiology, prevention and treatment of peri-implantitis--a review.

    PubMed

    Smeets, Ralf; Henningsen, Anders; Jung, Ole; Heiland, Max; Hammächer, Christian; Stein, Jamal M

    2014-01-01

    Peri-implant inflammations represent serious diseases after dental implant treatment, which affect both the surrounding hard and soft tissue. Due to prevalence rates up to 56%, peri-implantitis can lead to the loss of the implant without multilateral prevention and therapy concepts. Specific continuous check-ups with evaluation and elimination of risk factors (e.g. smoking, systemic diseases and periodontitis) are effective precautions. In addition to aspects of osseointegration, type and structure of the implant surface are of importance. For the treatment of peri-implant disease various conservative and surgical approaches are available. Mucositis and moderate forms of peri-implantitis can obviously be treated effectively using conservative methods. These include the utilization of different manual ablations, laser-supported systems as well as photodynamic therapy, which may be extended by local or systemic antibiotics. It is possible to regain osseointegration. In cases with advanced peri-implantitis surgical therapies are more effective than conservative approaches. Depending on the configuration of the defects, resective surgery can be carried out for elimination of peri-implant lesions, whereas regenerative therapies may be applicable for defect filling. The cumulative interceptive supportive therapy (CIST) protocol serves as guidance for the treatment of the peri-implantitis. The aim of this review is to provide an overview about current data and to give advices regarding diagnosis, prevention and treatment of peri-implant disease for practitioners. PMID:25185675

  18. Definition, etiology, prevention and treatment of peri-implantitis – a review

    PubMed Central

    2014-01-01

    Peri-implant inflammations represent serious diseases after dental implant treatment, which affect both the surrounding hard and soft tissue. Due to prevalence rates up to 56%, peri-implantitis can lead to the loss of the implant without multilateral prevention and therapy concepts. Specific continuous check-ups with evaluation and elimination of risk factors (e.g. smoking, systemic diseases and periodontitis) are effective precautions. In addition to aspects of osseointegration, type and structure of the implant surface are of importance. For the treatment of peri-implant disease various conservative and surgical approaches are available. Mucositis and moderate forms of peri-implantitis can obviously be treated effectively using conservative methods. These include the utilization of different manual ablations, laser-supported systems as well as photodynamic therapy, which may be extended by local or systemic antibiotics. It is possible to regain osseointegration. In cases with advanced peri-implantitis surgical therapies are more effective than conservative approaches. Depending on the configuration of the defects, resective surgery can be carried out for elimination of peri-implant lesions, whereas regenerative therapies may be applicable for defect filling. The cumulative interceptive supportive therapy (CIST) protocol serves as guidance for the treatment of the peri-implantitis. The aim of this review is to provide an overview about current data and to give advices regarding diagnosis, prevention and treatment of peri-implant disease for practitioners. PMID:25185675

  19. Composition of Human Peri-implantitis and Periodontitis Lesions

    PubMed Central

    Carcuac, O.; Berglundh, T.

    2014-01-01

    The aim of the present study was to examine differences in cellular characteristics of human peri-implantitis and periodontitis lesions. Two groups of patients were included: 40 patients with generalized severe chronic periodontitis and 40 patients presenting with severe peri-implantitis. Soft tissue biopsies were obtained from diseased sites (probing pocket depth ≥ 7 mm with bleeding on probing) and prepared for histologic and immunohistochemical analysis. In contrast to periodontitis samples, peri-implantitis lesions were more than twice as large and contained significantly larger area proportions, numbers, and densities of CD138-, CD68-, and MPO-positive cells than periodontitis lesions. Peri-implantitis lesions also extended to a position that was apical of the pocket epithelium and not surrounded by noninfiltrated connective tissue. They further presented with significantly larger densities of vascular structures in the connective tissue area lateral to the infiltrated connective tissue than within the infiltrate. This study suggests that peri-implantitis and periodontitis lesions exhibit critical histopathologic differences, which contribute to the understanding of dissimilarities in onset and progression between the 2 diseases. PMID:25261052

  20. Nonprocessed adipose tissue graft in the treatment of peri-implant osseous defects in the rabbit's tibiae: a pilot study.

    PubMed

    Zanicotti, Diogo Godoy; Matsubara, Fernanda Brugin; Zielak, João César; Giovanini, Allan Fernando; Urban, Cícero de Andrade; Deliberador, Tatiana Miranda

    2014-02-01

    We hypothesized that a new technique using nonprocessed adipose tissue could regenerate bone around dental implants. Eighteen rabbits received 1 implant per tibia surrounded by a surgically created osseous defect. The defects were assigned for treatment into 3 groups: C, AT, and AB. The percentages of bone-to-implant contact were 17.64% ± 16.22% (AB), 3.54% ± 7.08% (AT), and 12.71% ± 10.11% (C) (ρ = 0.25). The use of adipose tissue around surgically created peri-implant osseous defects interferes with bone formation. PMID:22103760

  1. Retrograde peri-implantitis.

    PubMed

    Mohamed, Jumshad B; Shivakumar, B; Sudarsan, Sabitha; Arun, K V; Kumar, T S S

    2010-01-01

    Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation. PMID:20922082

  2. Risk indicators related to peri-implant disease: an observational retrospective cohort study

    PubMed Central

    2016-01-01

    Purpose The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to pre-established clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (≥65 years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions Within the limitations of this study, patients aged ≥65 years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients. PMID:27588216

  3. Peri-implantitis: from diagnosis to therapeutics.

    PubMed

    Nguyen-Hieu, Tung; Borghetti, Alain; Aboudharam, Gérard

    2012-05-01

    Peri-implantitis is an infection of the tissue around an implant, resulting in the loss of supporting bone. Risk factors for peri-implantitis consist of a history of periodontitis, dental plaque, poor oral hygiene, smoking, alcohol consumption and diabetes. A clinical diagnosis indicates inflammatory signs including bleeding on probing with or without suppuration and a peri-implant pocket depth ≥5 mm. A radiograph shows images of marginal bone loss ≥2 mm. A differential diagnosis of peri-implant mucositis, occlusal overload, retrograde peri-implantitis and inflammatory implant periapical lesions suggests the appropriate treatment in each case. The non-surgical treatment of peri-implantitis, including a mechanical treatment alone or combined with antiseptics or antibiotics can improve clinical parameters in the short term but residual defects may still persist. Surgical treatment such as guided bone regeneration results in a gain of clinical attachment level and bone reconstruction in the long term. The limited effect of laser-assisted therapy needs to be further evaluated. The concept of prevention based on early detection and regular maintenance plays a principal role in reducing the occurrence of peri-implantitis. PMID:22383175

  4. Peri-Implant Diseases

    MedlinePlus

    ... and flossing and regular check-ups from a dental professional. Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking , and diabetes . It is essential to routinely ...

  5. The peri-implant esthetics: An unforgettable entity

    PubMed Central

    Dhir, Sangeeta

    2011-01-01

    Esthetic demands in today's world of dentistry are scaling new heights, and are driven by the zest to look beautiful. The soft tissue esthetics around implants is the foci of attention, which, if failed to meet, leads to unacceptable esthetic failure. The aim of this article is to give a brief overview of the various vital parameters influencing the esthetics governing the peri-implant area. PMID:21976830

  6. 68Ga-DOTA-Siglec-9 PET/CT imaging of peri-implant tissue responses and staphylococcal infections

    PubMed Central

    2014-01-01

    Background Staphylococcus epidermidis (S. epidermidis) has emerged as one of the leading pathogens of biomaterial-related infections. Vascular adhesion protein-1 (VAP-1) is an inflammation-inducible endothelial molecule controlling extravasation of leukocytes. Sialic acid-binding immunoglobulin-like lectin 9 (Siglec-9) is a leukocyte ligand of VAP-1. We hypothesized that 68Ga-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-conjugated Siglec-9 motif containing peptide (68Ga-DOTA-Siglec-9) could detect inflammatory response due to S. epidermidis peri-implant infection by positron emission tomography (PET). Methods Thirty Sprague-Dawley rats were randomized into three groups. A sterile catheter was implanted into the medullary canal of the left tibia. In groups 1 and 2, the implantation was followed by peri-implant injection of S. epidermidis or Staphylococcus aureus (S. aureus) with adjunct injections of aqueous sodium morrhuate. In group 3, sterile saline was injected instead of bacteria and no aqueous sodium morrhuate was used. At 2 weeks after operation, 68Ga-DOTA-Siglec-9 PET coupled with computed tomography (CT) was performed with the measurement of the standardized uptake value (SUV). The presence of the implant-related infection was verified by microbiological analysis, imaging with fluorescence microscope, and histology. The in vivo PET results were verified by ex vivo measurements by gamma counter. Results In group 3, the tibias with implanted sterile catheters showed an increased local uptake of 68Ga-DOTA-Siglec-9 compared with the intact contralateral bones (SUVratio +29.5%). 68Ga-DOTA-Siglec-9 PET detected inflammation induced by S. epidermidis and S. aureus catheter-related bone infections (SUVratio +58.1% and +41.7%, respectively). The tracer uptake was significantly higher in the S. epidermidis group than in group 3 without bacterial inoculation, but the difference between S. epidermidis and S. aureus groups was not statistically

  7. Locators versus magnetic attachment effect on peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture: a 1-year randomised trial.

    PubMed

    Elsyad, M A; Mahanna, F F; Elshahat, M A; Elshoukouki, A H

    2016-04-01

    This study aimed to evaluate peri-implant tissue health of immediate loaded two implants retaining a mandibular overdenture with either magnetic or locator attachment. Thirty two completely edentulous patients (20 males/12 females) were randomly assigned into two groups. Each patient received two implants in the canine area of the mandible using flapless surgical technique. Mandibular overdentures were immediately connected to the implants with either magnetic (group I, GI) or locator (group II, GII) attachments. Peri-implant tissue health was evaluated clinically in terms of plaque scores (PI), bleeding scores (BI), probing depth (PD), implant stability (ISQ) and interleukin-1-β (IL-1b) concentrations in peri-implant sulcular fluid. PI, BI and PD were measured at mesial, distal, buccal and lingual surfaces of each implant. Radiographic evaluation was performed in terms of vertical (VBL) and horizontal (HBLO) alveolar bone loss. Evaluations were performed 2 weeks (T0), 6 months (T1) and 12 months (T2) after overdenture insertion. Plague scores, PD, IL-1b, VBL and HBLO increased significantly with time. ISQ decreased significantly with time. BI showed no significant differences between observation times. GI recorded significant higher PI, ISQ and IL-1b at T2 compared to GII. GII recorded significant higher VBL than GI at T2 only. For HBLO, no significant differences between groups were noted. VBL and HBLO showed a significant positive correlation with PD. Locator attachments for immediate loaded implants retaining mandibular overdentures are associated with decreased plaque accumulation, decreased implant stability, decreased interleukin-1β concentration in peri-implant crevicular fluid and increased per-implant vertical bone loss compared to magnetic attachments after 1 year. PMID:26549496

  8. Dental implants with versus without peri-implant bone defects treated with guided bone regeneration

    PubMed Central

    Peñarrocha-Oltra, David; Peñarrocha-Diago, Maria; Peñarrocha-Diago, Miguel

    2015-01-01

    Background The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects. Material and Methods Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant survival, implant success and peri-implant marginal bone loss were assessed. Statistical analysis was performed with non-parametric tests setting an alpha value of 0.05. Results Seventy-two patients and 326 implants were included (142 test, 184 control). One hundred and twenty-five dehiscences (average height 1.92±1.11) and 18 fenestrations (average height 3.34±2.16) were treated. At 3 years post-loading, implant survival rates were 95.7% (test) and 97.3% (control) and implant success rates were 93.6% and 96.2%, respectively. Mean marginal bone loss was 0.54 (SD 0.26 mm) for the test group and 0.43 (SD 0.22 mm) for the control group. No statistically significant differences between both groups were found. Conclusions Within the limits of this study, implants with peri-implant defects treated with guided bone regeneration exhibited similar survival and success rates and peri-implant marginal bone loss to implants without those defects. Large-scale randomized controlled studies with longer follow-ups involving the assessment of esthetic parameters and hard and soft peri-implant tissue stability are needed. Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate. PMID:26330931

  9. Periodontal and peri-implant wound healing following laser therapy.

    PubMed

    Aoki, Akira; Mizutani, Koji; Schwarz, Frank; Sculean, Anton; Yukna, Raymond A; Takasaki, Aristeo A; Romanos, Georgios E; Taniguchi, Yoichi; Sasaki, Katia M; Zeredo, Jorge L; Koshy, Geena; Coluzzi, Donald J; White, Joel M; Abiko, Yoshimitsu; Ishikawa, Isao; Izumi, Yuichi

    2015-06-01

    Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal

  10. Peri-implant infections of oral biofilm etiology.

    PubMed

    Belibasakis, Georgios N; Charalampakis, Georgios; Bostanci, Nagihan; Stadlinger, Bernd

    2015-01-01

    Biofilms are complex microbial communities that grow on various surfaces in nature. The oral micobiota tend to form polymicrobial biofilms, particularly on the hard mineralized surfaces of teeth, which may impact on oral health and disease. They can cause inflammation of the adjacent tooth-supporting (periodontal) tissues, leading to destructive periodontal disease and tooth loss. The emergence of osseointegrated dental implants as a restorative treatment option for replacing missing teeth has also brought along new artificial surfaces within the oral cavity, on which oral bacteria can form biofilms. As in the case of natural teeth, biofilms on implant surfaces may also trigger infection and cause inflammatory destruction of the peri-implant tissue (i.e. peri-implantitis). While there are strong similarities in the composition of the mixed microbial flora between periodontal and peri-implant infections, there are also a few distinctive differences. The immunological events underlying the pathogenesis of peri-implant infections are qualitatively similar, yet more extensive, compared to periodontal infections, resulting in a faster progression of tissue destruction. This chapter summarizes the current knowledge on the microbiology and immunology of peri-implant infections, including findings from the peri-implant crevicular fluid, the inflammatory exudate of the peri-implant tissue. Moreover, it discusses the diagnosis and current approaches for the treatment of oral infections. PMID:25366221

  11. Regenerative Medicine for Periodontal and Peri-implant Diseases.

    PubMed

    Larsson, L; Decker, A M; Nibali, L; Pilipchuk, S P; Berglundh, T; Giannobile, W V

    2016-03-01

    The balance between bone resorption and bone formation is vital for maintenance and regeneration of alveolar bone and supporting structures around teeth and dental implants. Tissue regeneration in the oral cavity is regulated by multiple cell types, signaling mechanisms, and matrix interactions. A goal for periodontal tissue engineering/regenerative medicine is to restore oral soft and hard tissues through cell, scaffold, and/or signaling approaches to functional and aesthetic oral tissues. Bony defects in the oral cavity can vary significantly, ranging from smaller intrabony lesions resulting from periodontal or peri-implant diseases to large osseous defects that extend through the jaws as a result of trauma, tumor resection, or congenital defects. The disparity in size and location of these alveolar defects is compounded further by patient-specific and environmental factors that contribute to the challenges in periodontal regeneration, peri-implant tissue regeneration, and alveolar ridge reconstruction. Efforts have been made over the last few decades to produce reliable and predictable methods to stimulate bone regeneration in alveolar bone defects. Tissue engineering/regenerative medicine provide new avenues to enhance tissue regeneration by introducing bioactive models or constructing patient-specific substitutes. This review presents an overview of therapies (e.g., protein, gene, and cell based) and biomaterials (e.g., resorbable, nonresorbable, and 3-dimensionally printed) used for alveolar bone engineering around teeth and implants and for implant site development, with emphasis on most recent findings and future directions. PMID:26608580

  12. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report

    PubMed Central

    2015-01-01

    The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period. PMID:26064700

  13. Surgical Treatment of Peri-Implantitis: A 17-Year Follow-Up Clinical Case Report.

    PubMed

    Bassi, Fabrizio; Poli, Pier Paolo; Rancitelli, Davide; Signorino, Fabrizio; Maiorana, Carlo

    2015-01-01

    The purpose of the present case report was to describe the surgical treatment of a peri-implantitis lesion associated with a regenerative approach. A 48-year-old patient came to authors' attention 36 months after the placement of a dental implant (ITI-Bonefit Straumann, Waldenburg, Switzerland) in position 46. A swelling of the peri-implant soft tissues was observed, associated with bleeding on probing and probing depth > 10 mm. A significant peri-implant bone loss was clearly visible on the periapical radiograph. A nonsurgical periodontal supportive therapy was firstly conducted to reduce the inflammation, followed by the surgical treatment of the defect. After mechanical and chemical decontamination with tetracycline solution, a regenerative approach consisting in the application of deproteinized bovine bone mineral (Bio-Oss, Geistlich Pharma AG, Wolhusen, Switzerland) and a collagen membrane (Bio-Gide, Geistlich Pharma AG, Wolhusen, Switzerland) was performed. An antibiotic therapy was associated with the treatment. The 17-year follow-up showed a physiological probing depth with no clinical signs of peri-implant inflammation and bleeding on probing. No further radiographic bone loss was observed. The treatment described in the present case report seemed to show improved clinical results up to a relevant follow-up period. PMID:26064700

  14. Re-osseointegration after treatment of peri-implantitis at different implant surfaces. An experimental study in the dog.

    PubMed

    Persson, L G; Berglundh, T; Lindhe, J; Sennerby, L

    2001-12-01

    Peri-implantitis is a condition that includes soft tissue inflammation and rapid loss of bone. Treatment of peri-implantitis includes both antimicrobial and bone augmenting methods. The question of whether true re-osseointegration may occur following treatment of peri-implantitis is controversial. The aim of this study was to investigate whether the character of the implant surface was of importance for the occurrence of re-osseointegration following treatment of peri-implantitis. Four beagle dogs were used. The mandibular premolars were extracted. After 12 months, 3 ITI(R) solid screw dental implants were placed in each side of the mandible. In the left side, implants with a turned surface (Turned sites) were used, while in the right side implants with a SLA surface (SLA sites) were placed. After 3 months of healing, peri-implantitis was induced by ligature placement and plaque accumulation. When about 50% of the initial bone support was lost, the ligatures were removed. Five weeks later, treatment was initiated. Each animal received tablets of Amoxicillin and Metronidazole for a period of 17 days. Three days after the start of the antibiotic regimen, one implant site (experimental site) in each quadrant was exposed to local therapy. Following flap elevation, the exposed titanium surface was cleaned with the use of cotton pellets soaked in saline. The implants were submerged. Six months later, biopsies were obtained. Treatment resulted in a 72% bone fill of the bone defects at Turned sites and 76% at SLA sites. The amount of re-osseointegration was 22% at Turned sites and 84% at SLA sites. A treatment regimen that included (i) systemic administration of antibiotics combined with (ii) granulation tissue removal and implant surface cleaning resulted in resolution of peri-implantitis and bone fill in adjacent bone defects. Further, while substantial "re-osseointegration" occurred to an implant with a rough surface (SLA), bone growth on a previously exposed smooth

  15. Biomaterial and antibiotic strategies for peri-implantitis: a review.

    PubMed

    Norowski, P Andrew; Bumgardner, Joel D

    2009-02-01

    Dental implants have 89% plus survival rates at 10-15 years, but peri-implantitis or dental implant infections may be as high as 14%. Peri-implantitis can limit clinical success and impose health and financial burdens to patients and health providers. The pathogenic species associated with periodontitis (e.g., Fusobacterium ssp, A. actinomycetemcomitans, P. gingivalis) are also associated with peri-implantitis. Incidence of peri-implantitis is highest within the first 12 months after implantation, and is higher in patients who smoke or have poor oral health as well as with calcium-phosphate-coated or surface-roughened implants. Biomaterial therapies using fibers, gels, and beads to deliver antibiotics have been used in the treatment of Peri-implantitis though clinical efficacy is not well documented. Guided tissue regeneration membranes (e.g., collagen, poly-lactic/glycolic acid, chitosan, ePTFE) loaded with antimicrobials have shown success in reosseointegrating infected implants in animal models but have not been proven in humans. Experimental approaches include the development of anti-bioadhesion coatings, coating surfaces with antimicrobial agents (e.g., vancomycin, Ag, Zn) or antimicrobial releasing coatings (e.g., calcium phosphate, polylactic acid, chitosan). Future strategies include the development of surfaces that become antibacterial in response to infection, and improvements in the permucosal seal. Research is still needed to identify strategies to prevent bacterial attachment and enhance normal cell/tissue attachment to implant surfaces. PMID:18698626

  16. Effect of platelet-rich plasma on the peri-implant bone response: an experimental study.

    PubMed

    Fontana, Sebastián; Olmedo, Daniel Gustavo; Linares, Jorge Alberto; Guglielmotti, María Beatriz; Crosa, Marta Elena

    2004-03-01

    Platelet-rich plasma (PRP) is used as a source of growth factors to stimulate and accelerate bone formation and soft tissue healing. The use of PRP in bone regeneration, both around dental implants and in periodontic treatments, has become particularly appealing. The aim of this study was to evaluate the effect of PRP in an experimental model of osteogenesis around laminar implants. Fifteen male Wistar rats, weighing 90 +/- 10 g, were used in this study. One milliliter of blood was obtained from each animal by intracardiac puncture and transferred into Eppendorf tubes containing 10% sodium citrate. The tubes were centrifuged at 1500 rpm for 15 minutes and PRP was prepared. The laminar test was used to evaluate the bone peri-implant response. PRP and a titanium laminar implant were introduced into the right tibia (Ti/PRP group), whereas the left tibia (control) received only a laminar implant (Ti group). Thirty days postimplantation, the tibiae were resected, radiographed, and processed for embedding in acrylic resin. Ground sections (50 microm) were stained with toluidine blue. The peri-implant bone volume was evaluated histomorphometrically. Statistical analysis of the data was performed. The amount of newly formed bone in the Ti/PRP group (30 +/- 7 cm) was significantly greater than in the Ti group (16 +/- 3 cm). A greater volume of peri-implant bone was observed when PRP was used in the laminar implant test model. PMID:15017308

  17. Histomorphometric Assessment of the Influence of Low-Level Laser Therapy on Peri-Implant Tissue Healing in the Rabbit Mandible

    PubMed Central

    Gomes, Fernando Vacilotto; Mayer, Luciano; de Oliveira, Marília Gerhardt; Baraldi, Carlos Eduardo; Ponzoni, Deise; Puricelli, Edela

    2015-01-01

    Abstract Objective: The purpose of this study was to demonstrate the effect of low-level laser therapy (LLLT) on the peri-implant bone healing process in the rabbit mandible. Background data: LLLT has been shown to accelerate tissue repair and osseointegration of implants placed into the rabbit tibia. However, the beneficial effects of LLLT have never been tested in the rabbit mandible, which would more closely mimic the human situation. Materials and methods: Twenty-four male New Zealand rabbits were randomly divided into four groups of six animals each. All animals had their left mandibular incisors extracted, followed by immediate insertion of a titanium dental implant in the fresh socket. Three groups received LLLT [aluminum-gallium-arsenide (AlGaAs), λ=830nm, 50 mW, continuous wave (CW)] at three different energy densities per treatment session (E-5, 5 J/cm2; E-10, 10 J/cm2; and E-20, 20 J/cm2). Irradiation was performed every 48 h for 13 days, totaling seven sessions. One group received sham treatment (controls). Histological sections were obtained from each of the 24 mandibles dissected, without first decalcifying the specimens, and were stained with hematoxylin and eosin and Picrosirius red for histomorphometric evaluation. Bone-to-implant contact (BIC), bone formation area, and collagen fiber area were assessed by light microscopy. Results: Significant differences were found between group E-20 and all other groups (p<0.05). Histomorphometric evaluation showed significantly higher BIC and significantly more collagen fibers in group E-20. Conclusions: Photobiostimulation with LLLT at an energy density of 20 J/cm2 per session had a significant positive effect on new bone formation around dental implants inserted in the rabbit mandible. PMID:25751666

  18. The application of bone morphogenetic proteins to periodontal and peri-implant tissue regeneration: A literature review

    PubMed Central

    Sasikumar, Karuppanan P.; Elavarasu, Sugumari; Gadagi, Jayaprakash S.

    2012-01-01

    Progress in understanding the role of bone morphogenetic proteins (BMPs) in craniofacial and tooth development and the demonstration of stem cells in periodontal ligament have set the stage for periodontal regenerative therapy and tissue engineering. Furthermore, recent approval by the Food and Drug Administration of recombinant human BMPs for accelerating bone fusion in slow-healing fractures indicates that this protein family may prove useful in designing regenerative treatments in periodontics. In the near term, these advances are likely to be applied to periodontal surgery; ultimately, they may facilitate approaches to regenerating whole lost periodontal structures. PMID:23066304

  19. Regenerative Surgical Treatment of Peri-implantitis

    ClinicalTrials.gov

    2016-08-31

    Failure of Dental Implant Due to Infection; Infection; Inflammation; Peri-implantitis; Bacterial Infections; Bleeding of Subgingival Space; Molecular Sequence Variation; Periodontal Diseases; Mouth Diseases

  20. Clinical Management of a Peri-Implant Giant Cell Granuloma

    PubMed Central

    Pacifici, A.; Carbone, D.; Marini, R.; Sfasciotti, G. L.; Pacifici, L.

    2015-01-01

    Purpose. Implant therapy plays an important role in contemporary dentistry with high rates of long-term success. However, in recent years, the incidence of peri-implantitis and implant failures has significantly increased. The peripheral giant cell granuloma (PGCG) rarely occurs in peri-implant tissues and it is clinically comparable to the lesions associated with natural teeth. Therefore, the study of possible diseases associated with dental implants plays an important role in order to be able to diagnose and treat these conditions. Materials and Methods. This report described a 60-year-old Caucasian male who presented a reddish-purple pedunculated mass, of about 2 cm in diameter, associated with a dental implant and the adjacent natural tooth. Results. An excisional biopsy was performed and the dental implant was not removed. Histological examination provided the diagnosis of PGCG. After 19-month follow-up, there were no signs of recurrence of peri-implantitis around the implant. Conclusion. The correct diagnosis and appropriate surgical treatment of peri-implant giant cell granuloma are very important for a proper management of the lesion in order to preserve the implant prosthetic rehabilitation and prevent recurrences. PMID:26788379

  1. Arrangement of Peri-implant Connective Tissue Fibers Around Platform-Switching Implants with Conical Abutments and Its Relationship to the Underlying Bone: A Human Histologic Study.

    PubMed

    Rodríguez, Xavier; Navajas, Alvaro; Vela, Xavier; Fortuño, Angels; Jimenez, Jaime; Nevins, Myron

    2016-01-01

    The objective of this study was to clarify and evaluate the orientation of the collagen fibers around platform-switching (PS) implants with conical abutments in humans after 8 weeks of healing, and to determine how this orientation would help stabilize the soft tissue and prevent bone resorption. On PS implants, circular orientation of collagen fiber was observed as the main arrangement in a cross-sectional view. The circular collagen fibers might be the key factor in stabilizing the soft tissues around the rehabilitation, inhibiting apical migration of the soft tissues and, in turn, protecting the underlying bone. PMID:27333011

  2. The implant surface characteristics and peri-implantitis. An evidence-based update.

    PubMed

    Peixoto, C Davila; Almas, K

    2016-03-01

    Peri-implantitis is an inflammatory disease of the peri-implant mucosa with the loss of supporting bone. Because of the absence of an un-inflamed connective tissue zone between the healthy and diseased sites, peri-implant lesions are thought to progress more rapidly than periodontal lesions, suggesting the importance of early diagnosis and intervention if possible. A number of risk factors have been identified that may lead to the initiation and progression of peri-implant mucositis and peri-implantitis, eg., previous periodontal disease, poor plaque control, inability to clean, residual cement, smoking, genetic factors, diabetes, occlusal overload, rheumatoid arthritis, increased time of loading and alcohol consumption. At present there is not much literature available, highlighting the relationship between implant surface characteristics and peri-implant diseases. Implant surface characteristics vary with respect to topography, roughness and clinical composition, including turned, blasted, acid etched, porous sintered, oxidized, plasma sprayed and hydroxyapatite coated surfaces and their combinations. So the aim of this review is to explore the relationship between the characteristics of implant surface, the prevalence and incidence of peri-implantitis. This would help to identify plausible influence of surface characteristics, oral hygiene instructions and maintenance of implants for the long-term uneventful success of implant therapy. PMID:27434917

  3. NONSURGICAL PERIODONTAL MANAGEMENT OF IATROGENIC PERI-IMPLANTITIS: A CLINICAL REPORT.

    PubMed

    Roncati, M; Lauritano, D; Tagliabue, A; Tettamanti, L

    2015-01-01

    Dental implants have emerged as a first line of treatment to replace missing teeth for both the edentulous and partially dentate patients. The anticipated high degree of success is somewhat challenged by the onset of peri-implantitis. Peri-implant diseases are a cluster of “contemporary” oral infections in humans; they are characterized by the inflammatory destruction of the implant-supporting tissues, as a result of biofilm formation on the implant surface. It is still not clear how the roles of its etiologic agents work. A history of periodontitis, poor oral hygiene, and smoking are considered as risk factors for peri-implant diseases. Occasionally failing implants are associated with iatrogenic factors, that, only recently, have been acknowledged as direct cause of peri-implant complications, i.e.: non-parallel adjacent implants or the presence of a gap, between fixture and prosthetic components. The use both of traditional protocols of nonsurgical periodontal therapy and the diode laser seems to be an effective alternative treatment modality for peri-implantitis. By the application of laser-assisted non-surgical peri-implant therapy the periodontal pocket depth was reduced. Intraoral periapical radiographs, taken at 6 months and 1 year post nonsurgical treatment, seemed to provide evidence of some improvement of the bone level. The present article illustrates the nonsurgical management of one case, where failure to remove residual cement, from an implant-supported dental prosthesis, seemed to cause peri-implant inflammation. PMID:26511197

  4. Comparative biology of chronic and aggressive periodontitis vs. peri-implantitis.

    PubMed

    Heitz-Mayfield, Lisa J A; Lang, Niklaus P

    2010-06-01

    This review was undertaken to address the similarities and dissimilarities between the two disease entities of periodontitis and peri-implantitis. The overall analysis of the literature on the etiology and pathogenesis of periodontitis and peri-implantitis provided an impression that these two diseases have more similarities than differences. First, the initiation of the two diseases is dependent on the presence of a biofilm containing pathogens. While the microbiota associated with periodontitis is rich in gram-negative bacteria, a similar composition has been identified in peri-implant diseases. However, increasing evidence suggests that S. aureus may be an important pathogen in the initiation of some cases of peri-implantitis. Further research into the role of this gram-positive facultative coccus, and other putative pathogens, in the development of peri-implantitis is indicated. While the initial host response to the bacterial challenge in peri-implant mucositis appears to be identical to that encountered in gingivitis, persistent biofilm accumulation may elicit a more pronounced inflammatory response in peri-implant mucosal tissues than in the dentogingival unit. This may be a result of structural differences (such as vascularity and fibroblast-to-collagen ratios). When periodontitis and peri-implantitis were produced experimentally by applying plaque-retaining ligatures, the progression of mucositis to peri-implantitis followed a very similar sequence of events as the development of gingivitis to periodontitis. However, some of the peri-implantitis lesions appeared to have periods of rapid progression, in which the infective lesion reached the alveolar bone marrow. It is therefore reasonable to assume that peri-implantitis in humans may also display periods of accelerated destruction that are more pronounced than that observed in cases of chronic periodontitis. From a clinical point of view the identified and confirmed risk factors for periodontitis may be

  5. Marginal peri-implantitis due to occlusal overload. A case report.

    PubMed

    Uribe, Roberto; Peñarrocha, Miguel; Sanchis, Jose María; García, Oscar

    2004-01-01

    The etiology of marginal peri-implantitis describes an infectious factor and a biomechanical factor resulting from occlusal overload. Clinical and experimental articles oriented to the biomechanical factor are scarce, so as the studies about the histology associated to periimplantitis. We present a case of marginal peri-implantitis on an implant in the mandibular molar zone caused by occlusal overload, which led to an osseous defect on the marginal crest. The treatment was composed of occlusal adjustment, removal of contaminated surgical tissue, and autogenous bone graft, which varies from the common treatment of infectious peri-implantitis. Histologic analysis of peri-implantitis tissue reveals a juxtaepithelial lympho-plasmocytorious infiltrate and a central zone of dense fibro-connective tissue with scanty inflammatory cells, which differs from the chronic inflammatory tissue associated with infectious peri-implantitis. Clinical and radiographic followup control after 12 months evidenced the remission of the symptoms and bone regeneration on the marginal crest. We consider that in the treatment of marginal peri-implantitis, it is necessary to continue the studies on the histological differences between the infectious types and those that are caused by occlusal overload. PMID:14990883

  6. Treatment Alternatives to Negotiate Peri-Implantitis

    PubMed Central

    Machtei, Eli E.

    2014-01-01

    Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable. PMID:26556414

  7. Peri-Implant Sulcus Fluid (PISF) Matrix Metalloproteinase (MMP) -8 Levels in Peri-Implantitis

    PubMed Central

    Thierbach, René; Maier, Kurt; Sorsa, Timo

    2016-01-01

    Introduction Matrix Metalloproteinase (MMP) -8 plays crucial role in pathogenesis of periodontitis and is also a possible biomarker candidate in peri-implantitis. Aim The aim of the study was to analyse MMP-8 levels in peri-Implant Sulcus Fluid (PISF) from peri-implantitis affected implants in smoking and non-smoking patients with different periodontal health status of natural teeth before and after peri-implantitis treatment. Settings and Design Altogether 29 patients with peri-implantitis were recruited and divided into two study groups (11 with healthy periodontium or gingivitis, i.e. no marginal bone loss, and 18 with chronic periodontitis). Materials and Methods PISF sample from one implant with peri-implantitis from each patient was collected at the baseline and six months after conservative and surgical peri-implantitis treatment, and clinical parameters were registered. Samples were analysed for MMP-8 with dento ELISA method applying a monoclonal antibody. Mucosal cell samples were also analysed for IL-1 gene polymorphism. PISF MMP-8 levels’ differences between periodontal diagnosis groups and between smokers’ and non-smokers’ were analysed. Also, IL-1 polymorphism profiles were compared between study groups. Results PISF MMP-8 levels were higher at the baseline compared to and after the treatment when all sampled implant sites were analysed together (p = 0.001). MMP-8 levels’ distribution was broader in periodontitis patients’ PISF samples, and only in periodontitis patients’ group levels decreased statistically significantly after the treatment (p = 0.005). Smokers’and non-smokers’ PISF MMP-8 was at similar level both at the baseline and after the treatment. No difference between distributions of IL-1 genotypes was found between study groups. Conclusion MMP-8 levels increase in peri-implantitis affected implants both in non-periodontitis and periodontitis patients, but levels still after treatment of the condition reflect intensified host

  8. Periodontal and peri-implant diseases: identical or fraternal infections?

    PubMed

    Robitaille, N; Reed, D N; Walters, J D; Kumar, P S

    2016-08-01

    Peri-implant diseases (peri-implantitis and peri-implant mucositis) are bacterially driven infections. Peri-implantitis leads to aggressive bone resorption and eventual loss of the implant. Traditionally, peri-implantitis was regarded as microbially similar to periodontitis, and translocation of periodontal pathogens into the peri-implant crevice was considered as a critical factor in disease causation. However, evidence is emerging to suggest that the peri-implant and periodontal ecosystems differ in many important ways. The purpose of this review is to examine the evidence supporting microbial congruence and discordance in these two communities. Current evidence suggests that osseointegrated implants truly create unique microenvironments that force microbial adaptation and selection. Further studies that revisit the "microbial reservoir" hypothesis and identify species that play an etiologic role in peri-implant disease and examine their transmission from teeth are needed. PMID:26255984

  9. Microbiome of peri-implant infections: Lessons from conventional, molecular and metagenomic analyses

    PubMed Central

    Charalampakis, Georgios; Belibasakis, Georgios N

    2015-01-01

    Osseointegrated dental implants are now a well-established treatment option in the armament of restorative dentistry. These technologically advanced devices are designed to functionally and esthetically replace missing teeth. Despite the revolutionary advances that implants have incurred, they have also provided the oral cavity with new artificial surfaces prone to the formation of oral biofilms, similarly to the hard tissue surfaces of natural teeth. Biofilm formation on the implant surface can trigger the inflammatory destruction of the peri-implant tissue, in what is known as peri-implantitis. The mixed microbial flora of peri-implant infections resembles that of periodontal infections, with some notable differences. These are likely to expand with the ever increasing application of metagenomics and metatrascriptomics in the analysis of oral ecology. This review presents the wealth of knowledge we have gained from microbiological methods used in the characterization of peri-implant microflora and sheds light over potential new benefits, as well as limitations, of the new sequencing technology in our understanding of peri-implant disease pathogenesis. PMID:25654499

  10. Screw vs cement-implant-retained restorations: an experimental study in the beagle. Part 2. Immunohistochemical evaluation of the peri-implant tissues.

    PubMed

    Assenza, Bartolomeo; Artese, Luciano; Scarano, Antonio; Rubini, Corrado; Perrotti, Vittoria; Piattelli, Maurizio; Thams, Ulf; San Roman, Fidel; Piccirilli, Marcello; Piattelli, Adriano

    2006-01-01

    Crestal bone loss has been reported to occur around dental implants. Even if the causes of this bone loss are not completely understood, the presence of a microgap between implant and abutment with a possible contamination of the internal portion of the implants has been suggested. The aim of this study was to see if there were differences in the vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), proliferative activity (MIB-1), and inflammatory infiltrate in the soft tissues around implants with screwed and cemented abutments. Sandblasted and acid-etched implants were inserted in the mandibles of 6 Beagle dogs. Ten 3.5- x 10-mm root-form implants were inserted in each mandible. A total of 60 implants (30 with screwed abutments and 30 with cemented abutments) were used. After 12 months, all the bridges were removed and all abutments were checked for mobility. A total of 8 loosened screws (27%) were found in the screwed abutments, whereas no loosening was observed in cemented abutments. A gingival biopsy was performed in 8 implants with cemented abutments, in 8 implants with screwed abutments, and in 8 implants with unscrewed abutments. No statistically significant differences were found in the inflammatory infiltrate and in the MIB-1 among the different groups. No statistically significant difference was found in the MVD between screwed and cemented abutments (P = .2111), whereas there was a statistically significant difference in MVD between screwed and unscrewed abutments (P = .0277) and between cemented and unscrewed abutments (P = .0431). A low intensity of VEGF was prevalent in screwed and in cemented abutments, whereas a high intensity of VEGF was prevalent in unscrewed abutments. These facts could be explained by the effects induced, in the abutments that underwent a screw loosening, by the presence of bacteria inside the hollow portion of the implants or by enhanced reparative processes. PMID:16526575

  11. Necrotizing soft tissue infection

    MedlinePlus

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to the ...

  12. Necrotizing soft tissue infection

    MedlinePlus

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... the bacteria Streptococcus pyogenes , which is sometimes called "flesh-eating bacteria." Necrotizing soft tissue infection develops when ...

  13. Photodynamic therapy in peri-implantitis

    NASA Astrophysics Data System (ADS)

    Leretter, Marius; Cândea, Adrian; Topala, Florin

    2014-01-01

    Peri-implantitis is like Damocles sword, threatening over our final results as is the most common cause of implant failure. It is, was and will be one of the most challenging tasks for the practitioner to deal with. The rough implant surface offers the ideal conditions for the pathogenic bacteria to stick and multiply. Even more, the growing mature biofilm is harder to eliminate. Mechanical cleaning and rinsing is not capable to destroy it entirely. Most treatment protocols include strong antibiotics, disregarding their side effects and interactions with other medications.

  14. Peri-implantation Intercourse Lowers Fecundability

    PubMed Central

    Steiner, Anne Z.; Pritchard, David A.; Young, Steven L.; Herring, Amy H.

    2014-01-01

    Objective To determine the impact of sexual intercourse around the time of implantation on the probability of achieving a pregnancy. Design Time-to-pregnancy cohort using day-specific probability of pregnancy modeling to account for intercourse during the fertile window. Setting Community cohort. Patient(s) Women trying to conceive naturally, ages 30-44 without known infertility. Intervention(s) None. Main Outcome Measure(s) Positive pregnancy test Result(s) A total of 564 women provided 1,332 complete cycles for analysis. Intercourse frequency during the fertile window and during the peri-implantation window was significantly correlated. Cycles in which couples had 2 or more days with intercourse during the implantation window were significantly less likely to result in a positive pregnancy test compared to cycles in which couples didn’t have intercourse in this window, after adjusting for age, race, history of regular menstrual cycles, previous pregnancy, and body mass index (Fecundability Ratio=0.62, 95% Confidence Interval: 0.42-0.91). Conclusions Intercourse during the peri-implantation window may be detrimental to natural fertility. Methods that allow couples to time intercourse to the fertile window may decrease time to pregnancy by not only increasing the probability of fertilization but also decreasing the probability of failed implantation. PMID:24746744

  15. Peri-implant tissue response and biodegradation performance of a Mg-1.0Ca-0.5Sr alloy in rat tibia.

    PubMed

    Berglund, Ida S; Jacobs, Brittany Y; Allen, Kyle D; Kim, Stanley E; Pozzi, Antonio; Allen, Josephine B; Manuel, Michele V

    2016-05-01

    Biodegradable magnesium (Mg) alloys combine the advantages of traditional metallic implants and biodegradable polymers, having high strength, low density, and a stiffness ideal for bone fracture fixation. A recently developed Mg-Ca-Sr alloy potentially possesses advantageous characteristics over other Mg alloys, such as slower degradation rates and minimal toxicity. In this study, the biocompatibility of this Mg-Ca-Sr alloy was investigated in a rat pin-placement model. Cylindrical pins were inserted in the proximal tibial metaphyses in pre-drilled holes orthogonal to the tibial axis. Implant and bone morphologies were investigated using μCT at 1, 3, and 6 weeks after implant placement. At the same time points, the surrounding tissue was evaluated using H&E, TRAP and Goldner's trichrome staining. Although gas bubbles were observed around the degrading implant at early time points, the bone remained intact with no evidence of microfracture. Principle findings also include new bone formation in the area of the implant, suggesting that the alloy is a promising candidate for biodegradable orthopedic implants. PMID:26952400

  16. Decontamination Using a Desiccant with Air Powder Abrasion Followed by Biphasic Calcium Sulfate Grafting: A New Treatment for Peri-Implantitis

    PubMed Central

    Lombardo, Giorgio; Corrocher, Giovanni; Rovera, Angela; Pighi, Jacopo; Marincola, Mauro; Lehrberg, Jeffrey; Nocini, Pier Francesco

    2015-01-01

    Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis. PMID:26000178

  17. Decontamination using a desiccant with air powder abrasion followed by biphasic calcium sulfate grafting: a new treatment for peri-implantitis.

    PubMed

    Lombardo, Giorgio; Corrocher, Giovanni; Rovera, Angela; Pighi, Jacopo; Marincola, Mauro; Lehrberg, Jeffrey; Nocini, Pier Francesco

    2015-01-01

    Peri-implantitis is characterized by inflammation and crestal bone loss in the tissues surrounding implants. Contamination by deleterious bacteria in the peri-implant microenvironment is believed to be a major factor in the etiology of peri-implantitis. Prior to any therapeutic regenerative treatment, adequate decontamination of the peri-implant microenvironment must occur. Herein we present a novel approach to the treatment of peri-implantitis that incorporates the use of a topical desiccant (HYBENX), along with air powder abrasives as a means of decontamination, followed by the application of biphasic calcium sulfate combined with inorganic bovine bone material to augment the intrabony defect. We highlight the case of a 62-year-old man presenting peri-implantitis at two neighboring implants in positions 12 and 13, who underwent access flap surgery, followed by our procedure. After an uneventful 2-year healing period, both implants showed an absence of bleeding on probing, near complete regeneration of the missing bone, probing pocket depth reduction, and clinical attachment gain. While we observed a slight mucosal recession, there was no reduction in keratinized tissue. Based on the results described within, we conclude that the use of HYBENX and air powder abrasives, followed by bone defect grafting, represents a viable option in the treatment of peri-implantitis. PMID:26000178

  18. Diagnostic characteristics of clinical and microbiological tests for monitoring periodontal and peri-implant mucosal tissue conditions during supportive periodontal therapy (SPT).

    PubMed

    Luterbacher, S; Mayfield, L; Brägger, U; Lang, N P

    2000-12-01

    The aim of this study was to evaluate a clinical and a microbiological test for monitoring tissue condition during supportive periodontal therapy (SPT) and to compare their diagnostic characteristics at implant and tooth sites. Twelve female (age: 37-72 years) and 7 male patients (age: 26-83 years) were evaluated in this study on the basis of availability to follow a rigid SPT program. Patients had received a complete periodontal examination at 1 and 5 years after implant placement. This included standardized radiographs obtained at implants and matching control teeth. One implant site and one tooth site per patient were followed during the last 2 years of the SPT program. At each recall visit microbiological samples were analyzed according to DNA/RNA analysis identifying periodontal pathogens (IAI Pado Test 4.5, Institute for Applied Immunology, Zuchwil, Switzerland). Presence or absence of bleeding on probing at these sites was also noted using a standardized probing force of 0.25 N (Audio Probe, ESRO, Thalwil ZH, Switzerland). The percentage number of recall visits with positive bacteriological test results and positive BOP scores were calculated. Disease progression at the sites was defined if the annual increase in probing depth was > or = 0.5 mm/year (2.5 mm in 5 years) or if the annual decrease in CADIA values (Computer Assisted Densitometric Image Analysis) was more than -0.7 per year (-3.5 in 5 years). Changes below these values were considered as negative test results indicating stability of the sites. The diagnostic characteristics (sensitivity, specificity, positive and negative predictive values) of BOP and microbiological tests alone or in combination were then calculated using two-by-two tables. By application of increasing thresholds of BOP frequencies set for definition of positive test outcome (BOP > or = 10% > or = 20% > or = 25% > or = 50% > or = 75% > or = 90% or the combined BOP > or = 75%, but DNA positive > or = 10%, > or = 25% > or = 34

  19. Differences between buccal and lingual bone quality and quantity of peri-implant regions.

    PubMed

    Kim, Do-Gyoon; Elias, Kathy L; Jeong, Yong-Hoon; Kwon, Hyun-Jung; Clements, Matthew; Brantley, William A; Lee, Damian J; Han, Jung-Suk

    2016-07-01

    The objective of the current study was to examine whether peri-implant bone tissue properties are different between the buccal and lingual regions treated by growth factors. Four dental implant groups were used: titanium (Ti) implants, alumina-blasted zirconia implants (ATZ-N), alumina-blasted zirconia implants with demineralized bone matrix (DBM) (ATZ-D), and alumina-blasted zirconia implants with rhBMP-2 (ATZ-B). These implants were placed in mandibles of six male dogs. Nanoindentation elastic modulus (E) and plastic hardness (H) were measured for the buccal and lingual bone tissues adjacent and away from the implants at 3 and 6 weeks post-implantation. A total of 2281 indentations were conducted for 48 placed implants. The peri-implant buccal region had less bone quantity resulting from lower height and narrower width of bone tissue than the lingual region. Buccal bone tissues had significant greater mean values of E and H than lingual bone tissues at each distance and healing period (p<0.007). Nearly all implant treatment groups displayed lower mean values of the E at the lingual bone tissues than at the buccal bone tissues (p<0.046) although the difference was not significant for the Ti implant group (p=0.758). The DBM and rhBMP-2 treatments stimulated more peri-implant bone remodeling at the lingual region, producing more immature new bone tissues with lower E than at the buccal region. This finding suggests that the growth factor treatments to the zirconia implant system may help balance the quantity and quality differences between the peri-implant bone tissues. PMID:26773652

  20. A Regenerative Approach to the Successful Treatment of Peri-implantitis: A Consecutive Series of 170 Implants in 100 Patients with 2- to 10-Year Follow-up.

    PubMed

    Froum, Stuart J; Froum, Scott H; Rosen, Paul S

    2015-01-01

    This article presents the results of a consecutive case series of 170 treated peri-implantitis-affected implants in 100 patients with follow-up measurements from 2 to 10 years. A total of 51 implants in 38 patients previously reported on were followed for an additional 2.5 years, and 119 additional implants in 62 additional patients were treated with the same protocol and monitored for at least 2 years posttreatment. The treatment consisted of flap reflection, surface decontamination, use of enamel matrix derivative (EMD) or platelet-derived growth factor (PDGF), and guided bone regeneration with mineralized freezedried bone and/or anorganic bovine bone combined with PDGF or EMD and covered with an absorbable membrane and/or subepithelial connective tissue graft. Maintenance and monitoring followed every 2 to 3 months. Two implants were lost 6 months posttreatment, for a 98.8% survival rate. Bleeding on probing was eliminated in 91% of the treated implants. Probing depth reduction averaged 5.10 mm, bone level gain averaged 1.77 mm, and soft tissue marginal gain averaged 0.52 mm. These outcomes were obtained with one surgical procedure on 140 implants, with two procedures on 18 implants, and with three procedures on 10 implants. The results to date with this layered/combined regenerative approach for the treatment of peri-implantitis appear to be encouraging. PMID:26509990

  1. Prevalence of Porphyromonas gingivalis fimA genotypes in the peri-implant sulcus of Koreans assessed using a new primer

    PubMed Central

    2016-01-01

    Purpose Porphyromonas gingivalis fimA is a virulence factor associated with periodontal diseases, but its role in the pathogenesis of peri-implantitis remains unclear. We aimed to evaluate the relationship between the condition of peri-implant tissue and the distribution of P. gingivalis fimA genotypes in Koreans using a new primer. Methods A total of 248 plaque samples were taken from the peri-implant sulci of 184 subjects. The control group consisted of sound implants with a peri-implant probing depth (PD) of 5 mm or less with no bleeding on probing (BOP). Test group I consisted of implants with a peri-implant PD of 5 mm or less and BOP, and test group II consisted of implants with a peri-implant PD of more than 5 mm and BOP. DNA was extracted from each sample and analyzed a using a polymerase chain reaction (PCR) with P. gingivalis-specific primers, followed by an additional PCR assay to differentiate the fimA genotypes in P. gingivalis-positive subjects. Results The Prevalence of P. gingivalis in each group did not significantly differ (P>0.05). The most predominant fimA genotype in all groups was type II. The prevalence of type Ib fimA was significantly greater in test group II than in the control group (P<0.05). Conclusions The fimA type Ib genotype of P. gingivalis was found to play a critical role in the destruction of peri-implant tissue, suggesting that it may be a distinct risk factor for peri-implantitis. PMID:26937292

  2. The effect of loading on peri-implant bone: a critical review of the literature.

    PubMed

    Duyck, J; Vandamme, K

    2014-10-01

    In the 90s, there was a general belief that mechanical overloading was one of the main reasons for late implant failure. This triggered research to assess the role of mechanical loading on the establishment and the maintenance of oral implant osseointegration. Animal experimental studies indeed suggested the potential detrimental effect of excessive mechanical load on peri-implant bone, although randomised or controlled clinical trials of treatment interventions of oral implants designed to study overload are lacking. The lack of quantification of so-called overload at the implant level in the intra-oral setting is one of the main shortcomings in the literature. The level of evidence of the studies on bone response to implant loading is weak and does not indicate that overload can lead to peri-implant bone loss, except in case of inflammation. Clinical and animal experimental studies on early and immediate implant loading, however, provide information on the impact of mechanical loading on the process of osseointegration. It is obvious that micromotion between the implant and host tissues compromises osseointegration. However, in case of an efficient force transfer between implant and surrounding tissues, mechanical loading might even stimulate peri-implant bone formation and therefore osseointegration. PMID:24889500

  3. Nonsurgical Treatment of Peri-implantitis Using the Biofilm Decontamination Approach: A Case Report Study.

    PubMed

    Pini-Prato, Giovanpaolo; Magnani, Cristina; Rotundo, Roberto

    2016-01-01

    The aim of this preliminary study is to show the effect of the biofilm decontamination approach on peri-implantitis treatment. Clinical cases showing peri-implantitis were treated using an oral tissue decontaminant material that contains a concentrated aqueous mixture of hydroxybenzenesulfonic and hydroxymethoxybenzenesulfonic acids and sulfuric acid. The material was positioned in the pocket around the implant without anesthesia in nonsurgically treated cases. No instrumentation and no systemic or local antibiotics were used in any of the cases. A questionnaire was used for each patient to record the pain/discomfort felt when the material was administered. All of the treated cases healed well and rapidly. The infections were quickly resolved without complications. The momentary pain on introduction of the material was generally well tolerated and completely disappeared after a few seconds. The biofilm decontamination approach seems to be a very promising technique for the treatment of peri-implantitis. The local application of this material avoids the use of systemic or local antibiotics. PMID:27100808

  4. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics

    PubMed Central

    Ioannou, Andreas L.; Kotsakis, Georgios A.; McHale, Michelle G.; Lareau, Donald E.; Hinrichs, James E.; Romanos, Georgios E.

    2015-01-01

    Implant dentistry has been established as a predictable treatment with excellent clinical success to replace missing or nonrestorable teeth. A successful esthetic implant reconstruction is predicated on two fundamental components: the reproduction of the natural tooth characteristics on the implant crown and the establishment of soft tissue housing that will simulate a healthy periodontium. In order for an implant to optimally rehabilitate esthetics, the peri-implant soft tissues must be preserved and/or augmented by means of periodontal surgical procedures. Clinicians who practice implant dentistry should strive to achieve an esthetically successful outcome beyond just osseointegration. Knowledge of a variety of available techniques and proper treatment planning enables the clinician to meet the ever-increasing esthetic demands as requested by patients. The purpose of this paper is to enhance the implant surgeon's rationale and techniques beyond that of simply placing a functional restoration in an edentulous site to a level whereby an implant-supported restoration is placed in reconstructed soft tissue, so the site is indiscernible from a natural tooth. PMID:26124837

  5. Avian Soft Tissue Surgery.

    PubMed

    Guzman, David Sanchez-Migallon

    2016-01-01

    Basic surgical instrumentation for avian soft tissue surgery includes soft tissue retractors, microsurgical instrumentation, surgical loupes, and head-mounted lights. Hemostasis is fundamental during the surgical procedures. The indications, approach, and complications associated with soft tissue surgeries of the integumentary (digit constriction repair, feather cyst excision, cranial wound repair, sternal wound repair, uropygial gland excision), gastrointestinal (ingluviotomy, crop biopsy, crop burn repair, celiotomy, coelomic hernia and pseudohernia repair, proventriculotomy, ventriculotomy, enterotomy, intestinal resection and anastomosis, cloacoplasty, cloacopexy), respiratory (rhinolith removal, sinusotomy, tracheotomy, tracheal resection and anastomosis, tracheostomy, pneumonectomy) and reproductive (ovocentesis, ovariectomy, salpingohysterectomy, cesarean section, orchidectomy, vasectomy, phallectomy) systems are reviewed. PMID:26611927

  6. Ligature-induced peri-implant infection in crestal and subcrestal implants: a clinical and radiographic study in dogs

    PubMed Central

    Huang, Baoxin; Piao, Muzi; Zhang, Li; Wang, Xian’e; Xu, Li; Zhu, Weidong

    2015-01-01

    Objective. The aim of this study was to assess the influence of implant–abutment interface (IAI) placement depths on peri-implant tissues in the presence of ligature-induced peri-implant inflammation. Materials and Methods. Two implants with screwed-in IAIs (SI) and two implants with tapped-in IAIs (TI) were inserted in one side of the mandible in six dogs eight weeks after tooth extraction. Four experimental groups were constituted: SI placed crestally, SI placed 1.5 mm subcrestally, TI placed crestally and TI placed 1.5 mm subcrestally. After 12 weeks, the healing abutments were connected. Four weeks later, cotton floss ligatures were placed around the abutments to promote plaque accumulation. Clinical and radiographic examinations were performed at 0, 6 and 12 weeks after ligature placement. The effects of the IAI placement depths on clinical and radiographic parameters were assessed. Results. The alterations of peri-implant probing depths, clinical attachment levels, distances from the IAI to the first bone-implant contact (IAI-fBIC) and depths of infrabony defect were significant larger in the subcrestal groups compared with the crestal groups during the plaque accumulation period. The alterations of clinical attachment levels, IAI-fBIC, depth of the infrabony defect and horizontal bone loss were not significantly different between the SI and TI groups after ligature placement. Conclusion. Tissue destruction in subcrestal implants may be more serious than that in crestal implants in the presence of inflamed peri-implant mucosa. PMID:26246975

  7. Histological characteristics of peri-implant mucosa around Brånemark and single-crystal sapphire implants.

    PubMed

    Arvidson, K; Fartash, B; Hilliges, M; Köndell, P A

    1996-03-01

    Soft tissues surrounding Brånemark titanium implants and single crystal sapphire implants were studied by conventional light- and transmission electron microscopy and by immunohistochemical markers for cytokeratin, protein S-100, Factor VIII and KP1. Histological sections of biopsies obtained from clinically healthy peri-implant mucosa were separated into a keratinized outer implant epithelium and an inner, non-keratinized epithelium, both immunoreactive towards cytokeratin. The inner implant epithelium terminated in a junctional epithelium, apically not a few cell layers thick. The cells adjacent to the implant showed a condensed cytoplasm, resembling hemidesmosomes. In the underlying connective tissue, rich in fibroblasts and factor VIII immunoreactive blood vessels, the bundles of collagen ran in different directions. S-100 immunoreactive nerve structures were more frequently found beneath the outer than the inner implant epithelium. Inflammatory cell infiltrates, some KP1 positive, were observed in the apical parts of the inner implant epithelium. S-100 positive Langerhans' cells were present mainly within the the outer implant epithelium. For the two implant systems, the techniques disclosed no qualitative structural differences in the adjacent soft tissues. PMID:9002817

  8. Facial Soft Tissue Trauma

    PubMed Central

    Kretlow, James D.; McKnight, Aisha J.; Izaddoost, Shayan A.

    2010-01-01

    Traumatic facial soft tissue injuries are commonly encountered in the emergency department by plastic surgeons and other providers. Although rarely life-threatening, the treatment of these injuries can be complex and may have significant impact on the patient's facial function and aesthetics. This article provides a review of the relevant literature related to this topic and describes the authors' approach to the evaluation and management of the patient with facial soft tissue injuries. PMID:22550459

  9. Laser treatment of peri-implantitis: a literature review.

    PubMed

    Ashnagar, Sajjad; Nowzari, Hessam; Nokhbatolfoghahaei, Hanieh; Yaghoub Zadeh, Behnoush; Chiniforush, Nasim; Choukhachi Zadeh, Nastaran

    2014-01-01

    Peri-implantitis is a state defined as an inflammatory reaction around osseointegrated implants, leading to progressive loss of supporting bone. Various treatment methods are suggested in the treatment of peri-implantitis and clinicians have to choose a method over a large number of treatment protocols. Lasers have shown promising therapeutic effect in treatment of peri-implantitis. However, some controversies have been found in clinical outcomes after using lasers. Therefore, we aimed to review the current literature over the past ten years for the use of lasers in treatment of peri-implantitis, via the Pubmed electronic database of the US National Library of Medicine. Fifteen human studies were reviewed. Er:YAG (Erbium-Doped Yttrium Aluminum Garnet), CO2(Carbon Dioxide Laser) and Diode lasers were used. Despite inconsistencies and disharmonies among studies in terms of study design, positive treatment outcomes were obvious among the majority of them. However, short period of follow-ups and poor control of plaque index, as a critical confounding factor, were the major problems which these studies suffered from. It seems that one session laser therapy is not adequate for achieving optimal clinical outcome. Further studies with longer periods of follow-ups, intense control of plaque index, and various sessions of laser treatments are needed to clearly illustrate the clinical privilege of laser therapy. PMID:25653815

  10. Non-surgical periodontal treatment of peri-implant diseases with the adjunctive use of diode laser: preliminary clinical study.

    PubMed

    Lerario, Francesco; Roncati, Marisa; Gariffo, Annalisa; Attorresi, Enrica; Lucchese, Alessandra; Galanakis, Alexandros; Palaia, Gaspare; Romeo, Umberto

    2016-01-01

    Peri-implant diseases present in two forms: peri-implant mucositis and peri-implantitis. The prevalence of peri-implant complications is significantly rising. The aim of this study was to compare conventional treatment of inflamed peri-implant tissues with conventional treatment together with diode laser application. Twenty-seven patients (age 36 to 67, 15 women and 12 men, 12 smokers and 15 non-smokers) requiring treatment for mucositis or peri-implantitis were taken into account for this preliminary study. Plaque index (PI), pocket depth (PD), and bleeding on probing (BoP) were recorded at baseline evaluation. Patients in control group (CG) received conventional non-surgical periodontal treatment. Patients in test group received conventional non-surgical periodontal treatment together with diode laser application (810 nm, 30 s, 1 W, 50 Hz, t on = 100 ms, t off = 100 ms, energy density = 24.87 J/cm(2)). Paired t test was used to evaluate the difference in repeated measurements of considered indexes at T 0 and T 1 (1 year) in both groups. A total of 606 sites were taken into account in the test group (TG) and 144 in the CG. PD mean variation in the TG was 2.66 mm ± 1.07, while mean PD variation in the CG was 0.94 ± 1.13 mm. Paired t testing of the variation in PD in CG and TG revealed a statistically significant difference between the two groups (p < 0.0001). A reduction of pathological sites from 89 % (T 0) to 14.35 % (T 1) was achieved in the TG, while reduction obtained in the CG was from 75.69 % (T 0) to 50 % (T 1); BoP scores at time T 1 had fallen below 5 % in the TG and decreased to 59.7 %, in the CG. Within the limitations of this study, diode laser seems to be an additional valuable tool for peri-implant disease treatment. PMID:26188854

  11. Prevalence of Peri-Implant Mucositis and Peri-Implantitis in Patients Treated with a Combination of Axial and Tilted Implants Supporting a Complete Fixed Denture

    PubMed Central

    Cavalli, Nicolò; Taschieri, Silvio; Francetti, Luca

    2015-01-01

    Objectives. The aim of this retrospective study was to assess the incidence and prevalence of peri-implant mucositis and peri-implantitis in patients with a fixed full-arch prosthesis supported by two axial and two tilted implants. Materials and Methods. Sixty-nine patients were included in the study. Each patient received a fixed full-arch prosthesis supported by two mesial axial and two distal tilted implants to rehabilitate the upper arch, the lower arch, or both. Three hundred thirty-six implants for 84 restorations were delivered. Patients were scheduled for follow-up visits every 6 months in the first 2 years and yearly after. At each follow-up visit peri-implant mucositis and peri-implantitis were diagnosed if present. Results. The overall follow-up range was from 12 to 130 months (mean 63,2 months). Three patients presented peri-implantitis. The prevalence of peri-implant mucositis ranged between 0 and 7,14% of patients (5,06% of implants) while the prevalence of peri-implantitis varied from 0 to 4,55% of patients (3,81% of implants). Conclusions. The prevalence and incidence of peri-implant mucositis and peri-implantitis are lower than most of the studies in literature. Therefore this kind of rehabilitation could be considered a feasible option, on the condition of adopting a systematic hygienic protocol. PMID:26065029

  12. Adult soft tissue sarcoma

    MedlinePlus

    ... free at 5 years. Most people who survive 5 years can expect to be cancer-free at 10 years. ... most soft tissue sarcomas, and there is no way to prevent it. ... them can increase your chance of surviving this type of cancer.

  13. An in vivo assessment of the effects of using different implant abutment occluding materials on implant microleakage and the peri-implant microbiome

    NASA Astrophysics Data System (ADS)

    Rubino, Caroline

    Microleakage may be a factor in the progression of peri-implant pathology. Microleakage in implant dentistry refers to the passage of bacteria, fluids, molecules or ions between the abutment-implant interface to and from the surrounding periodontal tissues. This creates a zone of inflammation and reservoir of bacteria at the implant-abutment interface. Bone loss typically occurs within the first year of abutment connection and then stabilizes. It has not yet been definitively proven that the occurrence of microleakage cannot contribute to future bone loss or impede the treatment of peri-implant disease. Therefore, strategies to reduce or eliminate microleakage are sought out. Recent evidence demonstrates that the type of implant abutment channel occluding material can affect the amount of microleakage in an in vitro study environment. Thus, we hypothesize that different abutment screw channel occluding materials will affect the amount of observed microleakage, vis-a-vis the correlation between the microflora found on the abutment screw channel occluding material those found in the peri-implant sulcus. Additional objectives include confirming the presence of microleakage in vivo and assessing any impact that different abutment screw channel occluding materials may have on the peri-implant microbiome. Finally, the present study provides an opportunity to further characterize the peri-implant microbiome. Eight fully edentulous patients restored with at dental implants supporting screw-retained fixed hybrid prostheses were included in the study. At the initial appointment (T1), the prostheses were removed and the implants and prostheses were cleaned. The prostheses were then inserted with polytetrafluoroethylene tape (PTFE, TeflonRTM), cotton, polyvinyl siloxane (PVS), or synthetic foam as the implant abutment channel occluding material and sealed over with composite resin. About six months later (T2), the prostheses were removed and the materials collected. Paper

  14. The role of biomaterial properties in peri-implant neovascularization

    NASA Astrophysics Data System (ADS)

    Raines, Andrew Lawrence

    An understanding of the interactions between orthopaedic and dental implant surfaces with the surrounding host tissue is critical in the design of next generation implants to improve osseointegration and clinical success rates. Critical to the process of osseointegration is the rapid establishment of a patent neovasculature in the peri-implant space to allow for the delivery of oxygen, nutrients, and progenitor cells. The central aim of this thesis is to understand how biomaterials regulate cellular and host tissue response to elicit a pro-angiogenic microenvironment at the implant/tissue interface. To address this question, the studies performed in this thesis aim to (1) determine whether biomaterial surface properties can modulate the production and secretion of pro-angiogenic growth factors by cells, (2) determine the role of integrin and VEGF-A signaling in the angiogenic response of cells to implant surface features, and (3) to determine whether neovascularization in response to an implanted biomaterial can be modulated in vivo. The results demonstrate that biomaterial surface microtopography and surface energy can increase the production of pro-angiogenic growth factors by osteoblasts and that these growth factors stimulate the differentiation of endothelial cells in a paracrine manner and the results suggest that signaling through specific integrin receptors affects the production of angiogenic growth factors by osteoblast-like cells. Further, using a novel in vivo model, the results demonstrate that a combination of a rough surface microtopography and high surface energy can improve bone-to-implant contact and neovascularization. The results of these studies also suggest that VEGF-A produced by osteoblast-like cells has both an autocrine and paracrine effect. VEGF-A silenced cells exhibited reduced production of both pro-angiogenic and osteogenic growth factors in response to surface microtopgraphy and surface energy, and conditioned media from VEGF

  15. Effect of platform switching on the peri-implant bone: A finite element study

    PubMed Central

    Martínez-González, Amparo; Peiró, Germán; Ródenas, Juan-José; López-Mollá, María-Victoria

    2015-01-01

    Background There exists a relation between the presence and location of the micro-gap and the loss of peri implant bone. Several authors have shown that the treatments based on the use of platform switching result in less peri-implant bone loss and an increased tissue stability. The purpose of this study was to analyse the effect of the platform switching on the distribution of stresses on the peri-implant bone using the finite element method. Material and Methods A realistic 3D full-mandible finite element model representing cortical bone and trabecular bone was used to study the distribution of the stress on the bone induced by an implant of diameter 4.1 mm. Two abutments were modelled. The first one, of diameter 4.1 mm, was used in the reference model to represent a conventional implant. The second one, of diameter 3.2 mm, was used to represent the implant with platform switching. Both models were subjected to axial and oblique masticatory loads. Results The analyses showed that, although no relevant differences can be found for the trabecular bone, the use of platform switching reduces the maximum stress level in the cortical bone by almost 36% with axial loads and by 40% with oblique loads. Conclusions The full 3D Finite Element model, that can be used to investigate the influence of other parameters (implant diameter, connexion type, …) on the biomechanical behaviour of the implant, showed that this stress reduction can be a biomechanical reasons to explain why the platform switching seems to reduce or eliminate crestal bone resorption after the prosthetic restoration. Key words:Dental implant, platform switching, finite element method. PMID:26535094

  16. Is keratinized mucosa indispensable to maintain peri-implant health? A systematic review of the literature.

    PubMed

    Brito, Carlos; Tenenbaum, Howard C; Wong, Benjamin K C; Schmitt, Christian; Nogueira-Filho, Getulio

    2014-04-01

    The significance of keratinized mucosa (KM) around dental implants is still not well explained and has been controversial. The aim of this systematic review was to evaluate the importance of KM around dental implants. The electronic databases Cochrane library, MEDLINE, EMBASE, and Virtual Health Library (VHL) databases were utilized to search original articles from 2006 to March 2013. The inclusion and exclusion criteria used to select the articles were: (1) Human studies published in the English language; (2) Study published in international peer-viewed journals; (3) Studies evaluated the association between KM width and the peri-implant tissue health; (4) Studies that have follow up of greater than 12 months; (5) Publication of studies not older than 10 years. The searches retrieved 285 citations. Seven articles fulfilled all of the inclusion criteria. Out of these, three studies were ranked as presenting high methodological quality, and four were judged to be of moderate quality. This systematic review concludes that the presence of an adequate zone of keratinized tissue may be necessary because it was shown to be related to better peri-implant tissue health. Further randomized controlled trials are necessary to support this statement. PMID:24124021

  17. Volumetric Analysis of Gingival Crevicular Fluid and Peri-Implant Sulcus Fluid in Healthy and Diseased Sites: A Cross-Sectional Split-Mouth Pilot Study

    PubMed Central

    Bevilacqua, Lorenzo; Biasi, Matteo De; Lorenzon, Maria Giulia; Frattini, Costanza; Angerame, Daniele

    2016-01-01

    Background: Researchers have recently drawn attention to the analysis of gingival crevicular fluid (GCF) and peri-implant sulcus fluid (PISF) for the implementation of the diagnosis of periodontal and peri-implant disease. Nevertheless, the measurements of volume and biomarkers concentration can be critically biased when data collected from studies with parallel group design are compared, given the technical difficulties, methodological variables, as well as the variability of crevicular fluid characteristics among different individuals. Objective: The aim of the present study was to assess the GCF and PISF volumes in healthy and diseased sites belonging to the same patient. Method: Ten patients presenting a periodontally healthy tooth, a tooth with periodontitis, an implant with healthy peri-implant tissues and an implant with peri-implantitis were enrolled. Samples of GCF and PISF were collected from each site of interest and their volume measured with a Periotron 8000 device. Non-parametric statistical analysis was performed to test the significance of the differences in GCF and PISF volumes between i) sites of teeth and dental implants with the same condition of health or disease and ii) healthy and diseased sites of both teeth and dental implants subgroups. The correlation between probing pocket depth (PPD) and fluid production was also tested (p<0.05). Results: Healthy periodontal and peri-implant tissues produced comparable amounts of fluid that was significantly lower than in diseased sites (p<0.05). In the presence of diagnosed disease, the volumes of GCF and PISF were similar, too. The correlation between PPD and fluid production was significant only in healthy sites (PPD/GCF, ρ=0.890, p<0.001; PPD/PISF, ρ=0.810; p<0.005). Conclusion: The periodontal and peri-implant tissues behaved similarly in terms of fluid production in condition of both health and active disease. PMID:27335614

  18. Hypoelastic Soft Tissues

    PubMed Central

    Freed, Alan D.; Einstein, Daniel R.; Sacks, Michael S.

    2010-01-01

    In Part I, a novel hypoelastic framework for soft-tissues was presented. One of the hallmarks of this new theory is that the well-known exponential behavior of soft-tissues arises consistently and spontaneously from the integration of a rate based formulation. In Part II, we examine the application of this framework to the problem of biaxial kinematics, which are common in experimental soft-tissue characterization. We confine our attention to an isotropic formulation in order to highlight the distinction between non-linearity and anisotropy. In order to provide a sound foundation for the membrane extension of our earlier hypoelastic framework, the kinematics and kinetics of in-plane biaxial extension are revisited, and some enhancements are provided. Specifically, the conventional stress-to-traction mapping for this boundary value problem is shown to violate the conservation of angular momentum. In response, we provide a corrected mapping. In addition, a novel means for applying loads to in-plane biaxial experiments is proposed. An isotropic, isochoric, hypoelastic, constitutive model is applied to an in-plane biaxial experiment done on glutaraldehyde treated bovine pericardium. The experiment is comprised of eight protocols that radially probe the biaxial plane. Considering its simplicity (two adjustable parameters) the model does a reasonably good job of describing the non-linear normal responses observed in these experimental data, which are more prevalent than are the anisotropic responses exhibited by this tissue. PMID:21394222

  19. The basic science of peri-implant bone healing

    PubMed Central

    Kuzyk, Paul RT; Schemitsch, Emil H

    2011-01-01

    Given the popularity of cementless orthopedic implants, it is imperative for orthopedic surgeons to have a basic understanding of the process of peri-implant bone healing. Contact and distance osteogenesis have been used to explain peri-implant bone healing. In contact osteogenesis, de novo bone forms on the implant surface, while in distance osteogenesis, the bone grows from the old bone surface toward the implant surface in an appositional manner. Contact osteogenesis may lead to bone bonding if the surface of the implant displays the appropriate surface topography. The early stage of peri-implant bone healing is very important and involves the body’s initial response to a foreign material: protein adsorption, platelet activation, coagulation, and inflammation. This results in the formation of a stable fibrin clot that is a depot for growth factors and allows for osteoconduction. Osteoconduction is the migration and differentiation of osteogenic cells, such as pericytes, into osteoblasts. Osteoconduction allows for contact osteogenesis to occur at the implant surface. The late stage of healing involves the remodeling of this woven bone. In many respects, this process is similar to the bone healing occurring at a fracture site. PMID:21430864

  20. Resolution of ligature-induced peri-implantitis lesions in the dog.

    PubMed

    Marinello, C P; Berglundh, T; Ericsson, I; Klinge, B; Glantz, P O; Lindhe, J

    1995-06-01

    The present experiment in the Labrador dog was performed to study tissue alterations that occurred in a peri-implantitis lesion following ligature removal. The study was carried out in 5, 1-year old Labrador dogs. The mandibular right and left 1st molars and 4th and 3rd premolars were extracted to establish recipient sites for implants. After 3 months of healing, 4 titanium fixtures, 2 in each jaw quadrant, were installed and abutment connection carried out in a 2nd stage procedure after another 3 months. After a 6-month period of healing, cotton floss ligatures were placed in a submarginal position around the neck of the fixture abutments. The ligatures were forced into a position "apical" of the margin of the peri-implant mucosa and secured. When the tissue destruction after 4-6 weeks was found to amount to about 25% of the original bone height at each individual implant, the ligatures were removed. 2 dogs were sacrificed 1 month and 3 dogs 3 months after ligature removal. The animals were perfused with a fixative and block biopsies were obtained from the implant sites. The biopsies were prepared for histometric and morphometric analyses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7560227

  1. The biological seal of the implant–soft tissue interface evaluated in a tissue-engineered oral mucosal model

    PubMed Central

    Chai, Wen L.; Brook, Ian M.; Palmquist, Anders; van Noort, Richard; Moharamzadeh, Keyvan

    2012-01-01

    For dental implants, it is vital that an initial soft tissue seal is achieved as this helps to stabilize and preserve the peri-implant tissues during the restorative stages following placement. The study of the implant–soft tissue interface is usually undertaken in animal models. We have developed an in vitro three-dimensional tissue-engineered oral mucosal model (3D OMM), which lends itself to the study of the implant–soft tissue interface as it has been shown that cells from the three-dimensional OMM attach onto titanium (Ti) surfaces forming a biological seal (BS). This study compares the quality of the BS achieved using the three-dimensional OMM for four types of Ti surfaces: polished, machined, sandblasted and anodized (TiUnite). The BS was evaluated quantitatively by permeability and cell attachment tests. Tritiated water (HTO) was used as the tracing agent for the permeability test. At the end of the permeability test, the Ti discs were removed from the three-dimensional OMM and an Alamar Blue assay was used for the measurement of residual cells attached to the Ti discs. The penetration of the HTO through the BS for the four types of Ti surfaces was not significantly different, and there was no significant difference in the viability of residual cells that attached to the Ti surfaces. The BS of the tissue-engineered oral mucosa around the four types of Ti surface topographies was not significantly different. PMID:22915635

  2. Peri-implant squamous odontogenic tumor.

    PubMed

    Agostini, Tommaso; Sacco, Roberto; Bertolai, Roberto; Acocella, Alessandro; Colafranceschi, Maurizio; Lazzeri, Davide

    2011-05-01

    Squamous odontogenic tumor (SOT) is a benign, locally infiltrative intraosseous tumor composed of well-differentiated squamous epithelium in a fibrous stroma. It seems to derive from the epithelial rests of Malassez in the periodontal ligament space. It presents an odontogenic origin, involving both the upper and lower maxillary bone, mainly areas without teeth or connective tissue of the odontogenic cysts. Clinically, SOT could be asymptomatic (3 cases), notwithstanding it is mainly characterized by pain, swelling, and tooth/teeth mobility. The most typical presentation of SOT is a slowly growing endobony lesion arising within a single periodontal location. Frequent misdiagnosis concerns either ameloblastoma and squamous cell carcinoma and fibroma. Since its first description in 1975, less than 50 cases have been identified. In light of the few reported cases, there are no consistently recorded clinical and radiographic features of SOT, and there is no predictable sex or site predilection. Diagnosis is predicated on recognition of the histopathologic features of SOT to obviate possible misdiagnosis of malignancy or ameloblastoma.We report the first case of SOT that arose in the vicinity of an implant. Through a meticulous review of literature, we discuss current etiology, pathogenesis, and treatment. PMID:21586976

  3. Lasers in minimally invasive periodontal and peri-implant therapy.

    PubMed

    Mizutani, Koji; Aoki, Akira; Coluzzi, Donald; Yukna, Raymond; Wang, Chen-Ying; Pavlic, Verica; Izumi, Yuichi

    2016-06-01

    Laser therapy has the potential to be an effective, minimally invasive procedure in periodontal therapy. The aim of the present review was to survey the relevant literature on the clinical application of lasers as a minimally invasive treatment for periodontitis and peri-implant disease. Currently, there are a large number of published clinical studies and case reports that evaluate the adjunctive use of diode, carbon dioxide, neodymium-doped yttrium aluminium garnet (Nd:YAG), erbium-doped yttrium aluminium garnet (Er:YAG) and erbium, chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) lasers or antimicrobial photodynamic therapy for nonsurgical and minimally invasive surgical treatment of periodontal pockets. These procedures are expected not only to control inflammation but also to provide biostimulation effects with photonic energy. Recent meta-analyses did not show statistically significant differences in pocket reduction and clinical attachment gain compared with mechanical debridement alone, although limited positive effects of adjunctive laser therapy were reported. At present, systematic literature approaches suggest that more evidence-based studies need to be performed to support the integration of various laser therapies into the treatment of periodontal and peri-implant diseases. The disparity between previous statistical analyses and individual successful clinical outcomes of laser applications might reveal the necessity of developing optimal laser-treatment modalities of different wavelengths and better-defined indications for each protocol. PMID:27045437

  4. Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

    PubMed Central

    Chang, Hee-Yung; Park, Shin-Young; Kim, Jin-Ah; Kim, Young-Kyun

    2015-01-01

    Purpose This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant. Graphical Abstract PMID:26131368

  5. Assessment of dehydrothermally cross‐linked collagen membrane for guided bone regeneration around peri-implant dehiscence defects: a randomized single-blinded clinical trial

    PubMed Central

    2015-01-01

    Purpose The aim of this study was to determine the clinical feasibility of using dehydrothermally cross‐linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). Methods Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. Results Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. Conclusions These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects. PMID:26732806

  6. Soft tissue angiosarcomas

    SciTech Connect

    Morales, P.H.; Lindberg, R.D.; Barkley, H.T.

    1981-12-01

    From 1949 to 1979, 12 patients with soft tissue angiosarcoma received radiotherapy (alone or in combination with other modalities of treatment) with curative intent at The University of Texas M.D. Anderson Hospital and Tumor Institute. The primary site was the head and neck in six patients (scalp, four; maxillary antrum, one; and oral tongue, one), the breast in four patients, and the thigh in two patients. All four patients with angiosarcoma of the scalp had advanced multifocal tumors, and two of them had clinically positive neck nodes. None of these tumors were controlled locally, and local recurrences occurred within and/or at a distance from the generous fields of irradiation. The remaining two patients with head and neck lesions had their disease controlled by surgery and postoperative irradiation. Three of the four angiosarcomas of the breast were primary cases which were treated by a combination of surgery (excisional biopsy, simple mastectomy, radical mastectomy) and postoperative irradiation. One patient also received adjuvant chemotherapy. The fourth patient was treated for scar recurrence after radical mastectomy. All four patients had their disease locally controlled, and two of them have survived over 5 years. The two patients with angiosarcoma of the thigh were treated by conservative surgical excision and postoperative irradiation. One patient had her disease controlled; the other had a local recurrence requiring hip disarticulation and subsequent hemipelvectomy for salvage.

  7. Soft Tissue Stability around Single Implants Inserted to Replace Maxillary Lateral Incisors: A 3D Evaluation

    PubMed Central

    Mangano, F. G.; Picciocchi, G.; Park, K. B.

    2016-01-01

    Purpose. To evaluate the soft tissue stability around single implants inserted to replace maxillary lateral incisors, using an innovative 3D method. Methods. We have used reverse-engineering software for the superimposition of 3D surface models of the dentogingival structures, obtained from intraoral scans of the same patients taken at the delivery of the final crown (S1) and 2 years later (S2). The assessment of soft tissues changes was performed via calculation of the Euclidean surface distances between the 3D models, after the superimposition of S2 on S1; colour maps were used for quantification of changes. Results. Twenty patients (8 males, 12 females) were selected, 10 with a failing/nonrestorable lateral incisor (test group: immediate placement in postextraction socket) and 10 with a missing lateral incisor (control group: conventional placement in healed ridge). Each patient received one immediately loaded implant (Anyridge®, Megagen, Gyeongbuk, South Korea). The superimposition of the 3D surface models taken at different times (S2 over S1) revealed a mean (±SD) reduction of 0.057 mm (±0.025) and 0.037 mm (±0.020) for test and control patients, respectively. This difference was not statistically significant (p = 0.069). Conclusions. The superimposition of the 3D surface models revealed an excellent peri-implant soft tissue stability in both groups of patients, with minimal changes registered along time. PMID:27298621

  8. Emerging Issues Associated With Peri-implant Disease.

    PubMed

    Rosen, Paul S; Froum, Stuart J

    2016-07-01

    The biologic complication of peri-implantitis threatens the survival of dental implants that have successfully integrated and are in function. A list of seven risk factors associated with this disease was generated in 2006 at the Sixth European Workshop on Periodontology. These factors were based on the prevailing literature. Since then, modifications to this list have been considered whereby some of the original items suggested to be associated with periimplantitis would be deleted, while, in light of evidence-based information, newer, emerging risks may be included. A common theme seems to be that many of these factors can be associated with an inflammatory "dysbalance" tipping the scale toward ongoing bone loss beyond that considered physiologic modeling or remodeling. This article aims to highlight some of these emerging items with the hope that a strategy toward prevention or early detection and treatment may be employed, rather than waiting and requiring potentially extensive surgical procedures or implant removal. PMID:27548396

  9. Drugs Approved for Soft Tissue Sarcoma

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Soft Tissue Sarcoma This page lists ... soft tissue sarcoma that are not listed here. Drugs Approved for Soft Tissue Sarcoma Cosmegen (Dactinomycin) Dactinomycin ...

  10. Cytodiagnosis of soft tissue tumors.

    PubMed

    Oland, J; Rosen, A; Reif, R; Sayfan, J; Orda, R

    1988-03-01

    The only acceptable definitive diagnosis of a soft tissue mass is histologic or cytologic examination. In recent years, fine-needle aspiration cytology is used in more and more centers for diagnosis of soft tissue masses. We studied 196 aspiration cytologies performed on soft tissue lesions. Out of these, in 48 cases a definitive surgical procedure or open biopsy for histology and further evaluation were performed. There were 25 sarcomas and 23 benign tumors. There was one false negative cytologic result in this group; no false positive cytologies were detected. It seems that cytodiagnosis of soft tissue masses performed by an experienced pathologist is the method of choice, permitting a good diagnostic evaluation, with almost none of the traumatic and oncologic disadvantages of the other methods of biopsy. PMID:3352270

  11. Decontamination of dental implant surface in peri-implantitis treatment: A literature review

    PubMed Central

    Buitrago-Vera, Pedro; Solá-Ruiz, María F.; Ferrer-García, Juan C.

    2013-01-01

    Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics. Key words:Peri-implantitis, treatment, decontamination, implant surface, laser. PMID:23986023

  12. Prevalence of peri-implant disease on platform switching implants: a cross-sectional pilot study.

    PubMed

    Duque, Andrés Duque; Aristizabal, Astrid Giraldo; Londoño, Susana; Castro, Lida; Alvarez, Luis Gonzalo

    2016-01-01

    The objective of this study was to assess the prevalence of mucositis and peri-implantitis associated with the use of two types of implants-conventional versus platform switching after one year of loading. A longitudinal study of 64 implants in 25 patients was performed. Clinical variables, such as clinical pocket depth and bleeding upon probing, plaque, mobility, gingival recession, clinical attachment loss, and radiographic bone loss, were analyzed. The case definition for peri-implantitis was established as pockets of ≥ 5 mm with bleeding and bone loss ≥ 2 mm. One year after implant loading, the prevalence of mucositis and peri-implantitis with conventional implants (CIs) was 81.2% and 15.6%, respectively. For platform switching implants (PSIs) the prevalence was 90% and 6.6%, respectively. These differences were not statistically significant (p = 0.5375). However, there was a trend towards a lower prevalence of peri-implantitis with platform switching Implants. PMID:26676197

  13. Peri-implant disease: what we know and what we need to know

    PubMed Central

    2016-01-01

    Peri-implant disease is a serious problem that plagues today's dentistry, both in terms of therapy and epidemiology. With the expansion of the practice of implantology and an increasing number of implants placed annually, the frequency of peri-implant disease has greatly expanded. Its clinical manifestations, in the absence of a globally established classification, are peri-implant mucositis and peri-implantitis, the counterparts of gingivitis and periodontitis, respectively. However, many doubts remain about its features. Official diagnostic criteria, globally recognized by the dental community, have not yet been introduced. The latest studies using metagenomic methods are casting doubt on the assumption of microbial equivalence between periodontal and peri-implant crevices. Research on most of the features of peri-implant disease remains at an early stage; moreover, there is not a commonly accepted treatment for it. In any case, although the evidence so far collected is limited, we need to be aware of the current state of the science regarding this topic to better understand and ultimately prevent this disease. PMID:27382503

  14. Peri-implant disease: what we know and what we need to know.

    PubMed

    Valente, Nicola Alberto; Andreana, Sebastiano

    2016-06-01

    Peri-implant disease is a serious problem that plagues today's dentistry, both in terms of therapy and epidemiology. With the expansion of the practice of implantology and an increasing number of implants placed annually, the frequency of peri-implant disease has greatly expanded. Its clinical manifestations, in the absence of a globally established classification, are peri-implant mucositis and peri-implantitis, the counterparts of gingivitis and periodontitis, respectively. However, many doubts remain about its features. Official diagnostic criteria, globally recognized by the dental community, have not yet been introduced. The latest studies using metagenomic methods are casting doubt on the assumption of microbial equivalence between periodontal and peri-implant crevices. Research on most of the features of peri-implant disease remains at an early stage; moreover, there is not a commonly accepted treatment for it. In any case, although the evidence so far collected is limited, we need to be aware of the current state of the science regarding this topic to better understand and ultimately prevent this disease. PMID:27382503

  15. Patient-specific Analysis of Periodontal and Peri-implant Microbiomes

    PubMed Central

    Dabdoub, S.M.; Tsigarida, A.A.; Kumar, P.S.

    2013-01-01

    Periodontally involved teeth have been implicated as ‘microbial reservoirs’ in the etiology of peri-implant diseases. Therefore, the purpose of this investigation was to use a deep-sequencing approach to identify the degree of congruence between adjacent peri-implant and periodontal microbiomes in states of health and disease. Subgingival and peri-implant biofilm samples were collected from 81 partially edentulous individuals with periodontal and peri-implant health and disease. Bacterial DNA was isolated, and the 16S rRNA gene was amplified and sequenced by pyrotag sequencing. Chimera-depleted sequences were compared against a locally hosted curated database for bacterial identification. Statistical significance was determined by paired Student’s t tests between tooth-implant pairs. The 1.9 million sequences identified represented 523 species. Sixty percent of individuals shared less than 50% of all species between their periodontal and peri-implant biofilms, and 85% of individuals shared less than 8% of abundant species between tooth and implant. Additionally, the periodontal microbiome demonstrated significantly higher diversity than the implant, and distinct bacterial lineages were associated with health and disease in each ecosystem. Analysis of our data suggests that simple geographic proximity is not a sufficient determinant of colonization of topographically distinct niches, and that the peri-implant and periodontal microbiomes represent microbiologically distinct ecosystems. PMID:24158341

  16. [Skin and soft tissue infections].

    PubMed

    Piso, R J; Bassetti, S

    2012-03-14

    Skin- and Soft tissue infections are a frequent problem in hospital as well as in ambulatory care. Diagnostic procedures and treatment principles have to include the most frequent pathogens. While the acute forms of skin and soft tissue infections, with, necrotising fasciitis as important exception, rarely cause diagnostic or therapeutic problem, the treatment of patients with recurrent furunculosis, chronic wounds and diabetic feet is often difficult and frustration for patients and physicians. This article gives an overview of the most important problems and treatment strategies. PMID:22419138

  17. Soft tissue laser in orthodontics.

    PubMed

    Gracco, Antonio; Tracey, Stephen; Lombardo, Luca; Siciliani, Giuseppe

    2011-01-01

    Today a lot of minor cosmetic surgery operations on the gingiva can easily be carried out directly by the orthodontist with a small quantity of topical anaesthetic and the use of a soft tissue laser. The Diode laser is the most commonly used laser in dentistry for minor surgery to the soft tissues. This kind of laser offers numerous advantages with respect to traditional or electric scalpels. In this article the authors will analyse several typical uses of the diode laser in daily orthodontic practice. PMID:21515234

  18. Peri-implant evaluation of osseointegrated implants subjected to orthodontic forces: results after three years of functional loading

    PubMed Central

    Marins, Bruna de Rezende; Pramiu, Suy Ellen; Busato, Mauro Carlos Agner; Marchi, Luiz Carlos; Togashi, Adriane Yaeko

    2016-01-01

    ABSTRACT Objective: The objective of this study was to clinically and radiographically assess the peri-implant conditions of implants used as orthodontic anchorage. Methods: Two groups were studied: 1) a test group in which osseointegrated implants were used as orthodontic anchorage, with the application of 200-cN force; and 2) a control group in which implants were not subjected to orthodontic force, but supported a screw-retained prosthesis. Clinical evaluations were performed three, six and nine months after prosthesis installation and 1- and 3-year follow-up examinations. Intraoral periapical radiographs were obtained 30 days after surgical implant placement, at the time of prosthesis installation, and one, two and three years thereafter. The results were compared by Kruskal-Wallis test. Results: There was no statistically significant difference in clinical probing depth (p = 0.1078) or mesial and distal crestal bone resorption (p = 0.1832) during the study period. After three years of follow-up, the mean probing depth was 2.21 mm for the control group and 2.39 mm for the test group. The implants of the control group showed a mean distance between the bone crest and implant shoulder of 2.39 mm, whereas the implants used as orthodontic anchorage showed a mean distance of 2.58 mm at the distal site. Conclusion: Results suggest that the use of stable intraoral orthodontic anchorage did not compromise the health of peri-implant tissues or the longevity of the implant. PMID:27275618

  19. Comparative analysis of proteomic profiles between endometrial caruncular and intercaruncular areas in ewes during the peri-implantation period

    PubMed Central

    2013-01-01

    The endometrium of sheep consists of plenty of raised aglandular areas called caruncular (C), and intensely glandular intercaruncular areas (IC). In order to better understand the endometrium involved mechanisms of implantation, we used LC-MS/MS technique to profile the proteome of ovine endometrial C areas and IC areas separately during the peri-implantation period, and then compared the proteomic profiles between these two areas. We successfully detected 1740 and 1813 proteins in C areas and IC areas respectively. By comparing the proteome of these two areas, we found 170 differentially expressed proteins (DEPs) (P < 0.05), functional bioinformatics analysis showed these DEPs were mainly involved in growth and remodeling of endometrial tissue, cell adhesion and protein transport, and so on. Our study, for the first time, provided a proteomic reference for elucidating the differences between C and IC areas, as an integrated function unit respectively, during the peri-implantation period. The results could help us to better understand the implantation in the ewes. In addition, we established a relatively detailed protein database of ovine endometrium, which provide a unique reference for further studies. PMID:24093944

  20. Soft Tissue Response to Titanium Abutments with Different Surface Treatment: Preliminary Histologic Report of a Randomized Controlled Trial.

    PubMed

    Canullo, Luigi; Dehner, Jan Friedrich; Penarrocha, David; Checchi, Vittorio; Mazzoni, Annalisa; Breschi, Lorenzo

    2016-01-01

    The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups. PMID:27366741

  1. Soft Tissue Response to Titanium Abutments with Different Surface Treatment: Preliminary Histologic Report of a Randomized Controlled Trial

    PubMed Central

    Canullo, Luigi; Dehner, Jan Friedrich; Penarrocha, David; Checchi, Vittorio; Mazzoni, Annalisa; Breschi, Lorenzo

    2016-01-01

    The aim of this preliminary prospective RCT was to histologically evaluate peri-implant soft tissues around titanium abutments treated using different cleaning methods. Sixteen patients were randomized into three groups: laboratory customized abutments underwent Plasma of Argon treatment (Plasma Group), laboratory customized abutments underwent cleaning by steam (Steam Group), and abutments were used as they came from industry (Control Group). Seven days after the second surgery, soft tissues around abutments were harvested. Samples were histologically analyzed. Soft tissues surrounding Plasma Group abutments predominantly showed diffuse chronic infiltrate, almost no acute infiltrate, with presence of few polymorphonuclear neutrophil granulocytes, and a diffuse presence of collagenization bands. Similarly, in Steam Group, the histological analysis showed a high variability of inflammatory expression factors. Tissues harvested from Control Group showed presence of few neutrophil granulocytes, moderate presence of lymphocytes, and diffuse collagenization bands in some sections, while they showed absence of acute infiltrate in 40% of sections. However, no statistical difference was found among the tested groups for each parameter (p > 0.05). Within the limit of the present study, results showed no statistically significant difference concerning inflammation and healing tendency between test and control groups. PMID:27366741

  2. Pediatric soft tissue oral lesions.

    PubMed

    Pinto, Andres; Haberland, Christel M; Baker, Suher

    2014-04-01

    This article provides an overview of common color changes and soft tissue oral nodular abnormalities in children and adolescents. The clinical presentation and treatment options to address these conditions are presented in a concise approach, highlighting key features relevant to the oral health care professional. PMID:24655531

  3. Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis.

    PubMed

    Taschieri, Silvio; Weinstein, Roberto; Del Fabbro, Massimo; Corbella, Stefano

    2015-01-01

    Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained. PMID:26065025

  4. Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis

    PubMed Central

    Taschieri, Silvio; Weinstein, Roberto

    2015-01-01

    Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained. PMID:26065025

  5. Effects on titanium implant surfaces of chemical agents used for the treatment of peri-implantitis.

    PubMed

    Ungvári, Krisztina; Pelsöczi, István K; Kormos, Bernadett; Oszkó, Albert; Rakonczay, Zoltán; Kemény, Lajos; Radnai, Márta; Nagy, Katalin; Fazekas, András; Turzó, Kinga

    2010-07-01

    The treatment of peri-implantitis, which causes tissue deterioration surrounding osseointegrated implants, involves surface decontamination and cleaning. However, chemical cleaning agents may alter the structure of implant surfaces. We investigated three such cleaning solutions. Commercially pure (grade 4) machined titanium discs (CAMLOG Biotechnologies AG, Switzerland) were treated with 3% H(2)O(2) (5 min), saturated citric acid (pH = 1) (1 min) or chlorhexidine gel (5 min), and their surface properties were examined by atomic force microscopy (AFM) and X-ray photoelectron spectroscopy (XPS). Human epithelial cell attachment (24-h observation) and proliferation (72-h observation) were investigated via dimethylthiazolyl-diphenyltetrazolium bromide (MTT) and bicinchoninic acid (BCA) protein content assays. AFM revealed no significant difference in roughness of the three treated surfaces. XPS confirmed the constant presence of typical surface elements and an intact TiO(2) layer on each surface. The XPS peaks after chlorhexidine gel treatment demonstrated C-O and/or C=O bond formation, due to chlorhexidine digluconate infiltrating the surface. MTT and BCA assays indicated similar epithelial cell attachments in the three groups; epithelial cell proliferation being significantly higher after H(2)O(2) than after chlorhexidine gel treatment (not shown by BCA assays). These agents do not harm the Ti surface. Cleaning with H(2)O(2) slightly enhances human epithelial cell growth, in contrast to chlorhexidine gel. PMID:20524198

  6. Decontamination of dental implant surface in peri-implantitis treatment: a literature review.

    PubMed

    Mellado-Valero, Ana; Buitrago-Vera, Pedro; Solá-Ruiz, María-Fernanda; Ferrer-García, Juan-Carlos

    2013-11-01

    Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics. PMID:23986023

  7. Childhood Soft Tissue Sarcoma: Treatment Information

    MedlinePlus

    ... Germ Cell Tumors Kidney/Wilms Tumor Liver Cancer Neuroblastoma Osteosarcoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma Thyroid ... Tumor Liver Cancer Lymphoma (Non-Hodgkin) Lymphoma (Hodgkin) Neuroblastoma Osteosarcoma Retinoblastoma Rhabdomyosarcoma Skin Cancer Soft Tissue Sarcoma ...

  8. General Information about Adult Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Adult Soft Tissue Sarcoma Go to Health ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  9. General Information about Childhood Soft Tissue Sarcoma

    MedlinePlus

    ... Soft Tissue Sarcoma Treatment (PDQ®)–Patient Version General Information About Childhood Soft Tissue Sarcoma Go to Health ... the PDQ Pediatric Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  10. [Radiotherapy of adult soft tissue sarcoma].

    PubMed

    Le Péchoux, C; Moureau-Zabotto, L; Llacer, C; Ducassou, A; Sargos, P; Sunyach, M P; Thariat, J

    2016-09-01

    Incidence of soft tissue sarcoma is low and requires multidisciplinary treatment in specialized centers. The objective of this paper is to report the state of the art regarding indications and treatment techniques of main soft tissue sarcoma localisations. PMID:27523415

  11. Survival by Stage of Soft Tissue Sarcoma

    MedlinePlus

    ... Next Topic How are soft tissue sarcomas treated? Survival by stage of soft tissue sarcoma Survival rates ... observed, not relative survival): Stage 5-year observed survival rate I 90% II 81% III 56% IV ...

  12. Concomitant Correction of a Soft-Tissue Fenestration with Keratinised Tissue Augmentation By Using A Rotated Double-Pedicle Flap During Second-Stage Implant Surgery- A Case Report

    PubMed Central

    Reddy, Aileni Amarender; Kumar, P. Anoop; Sailaja, Sistla; Chakravarthy, Yshs

    2015-01-01

    Soft tissue deficiencies and defects around dental implants have been observed frequently. Soft-tissue defects after implant procedures originate from the process of modelling of periimplant mucosa and often cause aesthetic disharmony, food debris accumulation and soft tissue shrinkage. Periimplant mucogingival surgery focuses on creating an optimum band of keratinized tissue resulting in soft tissue architecture similar to the gingiva around natural teeth. A 23-year-old male reported to the Department of Periodontology with a complaint of gum soreness, foul smell and food accumulation at a site where a 3.75 x 11.5mm implant was placed previously. On clinical examination, fenestration of tissue above the cover screw was observed and there appeared to be a keratinized tissue of 1mm surrounding the implant. The case was managed by use of a rotated double-pedicle flap during second-stage implant surgery to correct the soft-tissue fenestration defect and to obtain a keratinized periimplant soft tissue. A periosteal bed was prepared by giving a horizontal incision at the mucogingival junction to a depth of 4 mm. Two split-thickness keratinized pedicles were dissected from the mesial and distal interproximal tissues near the implant. After rotation, both the pedicles were sutured to each other mid-buccally and the pedicles were rigidly immobilized with sutures. At 1 month, there was a 3mm band of stable and firm keratinized tissue over the underlying tissues. The procedure resulted in an aesthetic improvement due to enhanced soft tissue architecture and optimum integration between the peri-implant soft tissue and the final prosthesis. PMID:26816998

  13. Bone and Soft Tissue Ablation

    PubMed Central

    Foster, Ryan C.B.; Stavas, Joseph M.

    2014-01-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  14. Bone and soft tissue ablation.

    PubMed

    Foster, Ryan C B; Stavas, Joseph M

    2014-06-01

    Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan. PMID:25053865

  15. Retrospective study on bone-level and soft-tissue-level cylindrical implants.

    PubMed

    Lopez, M A; Andreasi Bassi, M; Confalone, L; Gaudio, R M; Lombardo, L; Lauritano, D

    2016-01-01

    The purpose of this prospective clinical study was to evaluate the survival rate (SVR - i.e. fixtures still in place at the end of the observation period) and success rate (SCR - i.e. bone resorption around implant neck) of two cylindrical implant systems. Both systems were equipped with a tapered connection, one requiring a bone-level (BL) placement, while the other a soft-tissue-level (STL) placement. In the period between January 1996 and October 2011, a total of 150 implants (76 in females and 74 in males, mean age 60±11 years) were inserted. The mean post-surgical follow-up was 84±47 months. Several parameters were evaluated as potential outcome conditioners: age, gender, diabetes, smoking, periodontitis, type of edentulism, replaced tooth, jaw location (i.e. maxilla or mandible), bone graft, immediate loading, post-extractive, type of prosthesis, implant diameter and length. An SPSS program was used for statistical analysis. Only two fixtures were lost, therefore SVR was 98.7%. SCR, expressed through the mean marginal bone loss, was 92%. The mean peri-implant bone loss was 0.121.47 mm for BL implants and 0.041.3 mm for STL implants. None of the studied variables had a statistical significant impact on SVR or SCR. Cylindrical implants are reliable for oral rehabilitation. PMID:27469547

  16. Peri-Implantation Hormonal Milieu: Elucidating Mechanisms of Abnormal Placentation and Fetal Growth1

    PubMed Central

    Mainigi, Monica A.; Olalere, Devvora; Burd, Irina; Sapienza, Carmen; Bartolomei, Marisa; Coutifaris, Christos

    2013-01-01

    ABSTRACT Assisted reproductive technologies (ART) have been associated with several adverse perinatal outcomes involving placentation and fetal growth. It is critical to examine each intervention individually in order to assess its relationship to the described adverse perinatal outcomes. One intervention ubiquitously used in ART is superovulation with gonadotropins. Superovulation results in significant changes in the hormonal milieu, which persist during the peri-implantation and early placentation periods. Epidemiologic evidence suggests that the treatment-induced peri-implantation maternal environment plays a critical role in perinatal outcomes. In this study, using the mouse model, we have isolated the exposure to the peri-implantation period, and we examine the effect of superovulation on placentation and fetal growth. We report that the nonphysiologic peri-implantation maternal hormonal environment resulting from gonadotropin stimulation appears to have a direct effect on fetal growth, trophoblast differentiation, and gene expression. This appears to be mediated, at least in part, through trophoblast expansion and invasion. Although the specific molecular and cellular mechanism(s) leading to these observations remain to be elucidated, identifying this modifiable risk factor will not only allow us to improve perinatal outcomes with ART, but help us understand the pathophysiology contributing to these outcomes. PMID:24352558

  17. Antimicrobial mouthrinse use as an adjunct method in peri-implant biofilm control.

    PubMed

    Pedrazzi, Vinicius; Escobar, Elaine Cristina; Cortelli, José Roberto; Haas, Alex Nogueira; Andrade, Ana Karina Pinto de; Pannuti, Claudio Mendes; Almeida, Eliete Rodrigues de; Costa, Fernando Oliveira; Cortelli, Sheila Cavalca; Rode, Sigmar de Mello

    2014-01-01

    Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease. PMID:25003787

  18. ZINC INFLUENCES THE IN VITRO DEVELOPMENT OF PERI-IMPLANTATION MOUSE EMBRYOS

    EPA Science Inventory

    Background: For humans, it is estimated that over 70% of concepti are lost during early development. In culture, mouse peri-implantation embryos can mimic development from the blastocyst to the egg cylinder stage of development, a period during which implantation occurs in viv...

  19. Biological markers during early pregnancy: trophoblastic signals of the peri-implantation period

    SciTech Connect

    Glasser, S.R.; Julian, J.; Munir, M.I.; Soares, M.J.

    1987-10-01

    The peri-implantation period extends from the time the blastocyst is free in the uterus, through the processes of recognition and attachment, to the beginning of trophoblast differentiation and the interactions between the embryo and the uterine endometrium which initiate establishment of the hemochorial placenta. It is during the peri-implantation period that the embryo and hormonally regulated endometrial cells appear to be most sensitive to factors which introduce risk into the intrauterine environment. There are no markers which can be used practically to assess pregnancy risk during the peri-implantation period of either human or laboratory rodents. Experimental studies, using in vitro laboratory models of differentiating trophoblasst cells, have identified peptide hormone markers of pivotal developmental processes. Exposure of trophoblast during the expression of these processes could have severe and far-reaching effects individually and societally. Human chorionic gonadotropin (hCG) has been used extensively as a marker to assess risk during the early stages of pregnancy. Extrapolation of experimental data indicates how hCG could be used more effectively in analyses of possible cause and effect relationships. The limitations of hCG as a marker for risk during the human peri-implantation period are discussed. Peptide hormones which could serve to assess risk during this critical period of extraordinary sensitivity to toxic factors are introduced.

  20. Systemic antibiotics and the risk of superinfection in peri-implantitis.

    PubMed

    Verdugo, Fernando; Laksmana, Theresia; Uribarri, Agurne

    2016-04-01

    Peri-implantitis has emerged in the last few years as a complication difficult to resolve. The etiopathogenesis consensus is mainly attributed to bacteria. Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, a PubMed/Medline literature search was performed using the US National Library of Medicine database up to 2015 to analyze available scientific data on the rationale and risk of superinfection associated to systemic antimicrobials in human peri-implant disease. A hand search was also conducted on relevant medical and microbiology journals. The methodological index for non-randomized studies (MINORS) was independently assessed for quality on the selected papers. Proposed combined therapies use broad-spectrum antibiotics to halt the disease progression. A major associated risk, particularly when prescribed empirically without microbiological follow-up, is the undetected development of superinfections and overgrowth of opportunistic pathogens difficult to eradicate. Peri-implant superinfections with opportunistic bacteria, yeast and viruses, are plausible risks associated to the use of systemic antibiotics in immunocompetent individuals. Lack of microbiological follow-up and antibiotic susceptibility testing may lead to ongoing microbial challenges that exacerbate the disease progression. The increased proliferation of antimicrobial resistance, modern implant surface topography and indiscriminative empiric antibiotic regimens may promote the escalation of peri-implant disease in years to come. A personalized 3-month supportive therapy may help prevent risks by sustaining a normal ecological balance, decreasing specific pathogen proportions and maintaining ideal plaque control. PMID:26761363

  1. Clinical and radiographic evaluation of periodontal and peri-implant conditions in patients with implant-supported prosthesis.

    PubMed

    Abreu, Monica H; Bianchini, Marco A; Magini, Ricardo S; Rösing, Cassiano K

    2007-01-01

    The aim of the present study was to clinically and radiographically assess the peri-implant and periodontal conditions in partially edentulous patients with implant-supported fixtures installed, at least, one year prior to the study. 41 patients were examined by a calibrated examiner in relation to the following implant-associated parameters: Modified Plaque Index (mPlI), Modified Bleeding Index (mBI), probing depth (PD), clinical attachment level (CAL) and bleeding on probing of the bottom of the crevice (BOP). Also, the remaining teeth were assessed in terms of Plaque Index (PlI), Gingival Index (GI), PD, CAL and BOP. The peri-implant bone loss was evaluated by means of periapical radiographs. Measurements of pre-operatory and final bone levels allowed an estimation of bone loss associated to teeth and a comparison with bone loss around implants. None of the individuals presented late loss of implants until the examination took place. No statistically significant differences were observed between PlI (0.90+/-0.07) and mPlI (0.82+/-0.13), or between GI (0.11+/-0.02) and mBI (0.10+/-0.02). However, PD, CAL and BOP values were higher in implants than in teeth (Wald Test, p<0.01). Implants presented a mean annual bone loss during the study period of 0.77 mm (SE=0.06). Teeth virtually did not present any bone loss (mean value of 0.36%) whereas implants exhibited a bone loss value of 17.11%. Plaque accumulation and marginal inflammation did not differ between teeth and implants. However, subgingival inflammation was higher in implants than in teeth. The destruction measurements suggest greater losses in implants, as expected because of tissue remodelation. PMID:18590257

  2. Resolution of peri-implantitis following treatment. An experimental study in the dog.

    PubMed

    Persson, L G; Araújo, M G; Berglundh, T; Gröndahl, K; Lindhe, J

    1999-06-01

    The aim of the present experiment was i) to study the effect of anti-microbial therapy of experimentally induced peri-implantitis lesions and ii) to assess features of bone regrowth following treatment. Four beagle dogs were used. Three titanium fixtures (Brånemark System) were installed in each quadrant of the mandible (premolars previously extracted). Abutment connection was performed 5 months later and ligature induced breakdown was initiated. The ligatures were removed when approximately 50% of the initial bone support was lost. A 3-week antibiotic regimen (amoxicillin and metronidazole) was initiated 1 month later. Two days after the start of the antibiotic administration, the experimental implant sites were exposed to local therapy. The abutments were removed and the exposed fixture surfaces were treated with an abrasive (pumice) administered via a rotating brush (left side) or cleaned with cotton pellets soaked in saline (right side). Cover screws were attached to the fixtures and the implants were submerged. Fluorochromes were injected intravenously 2 weeks, 4 weeks and 12 weeks after surgery. The animals were killed 7 months after surgery and block biopsies of each implant site were dissected and prepared for histological analysis. The findings of the examinations disclosed that the inflammatory lesion was resolved and new bone formation had occurred in the previous defect following antimicrobial and local therapy. The amount of "re-osseointegration" that had taken place, however, was small. Indeed, at all experimental implant sites, a thin connective tissue capsule was found to separate the implant surface from the newly formed bone. PMID:10522179

  3. Screw insertion in trabecular bone causes peri-implant bone damage.

    PubMed

    Steiner, Juri A; Ferguson, Stephen J; van Lenthe, G Harry

    2016-04-01

    Secure fracture fixation is still a major challenge in orthopedic surgery, especially in osteoporotic bone. While numerous studies have investigated the effect of implant loading on the peri-implant bone after screw insertion, less focus has been put on bone damage that may occur due to the screw insertion process itself. Therefore, the aim of this study was to localize and quantify peri-implant bone damage caused by screw insertion. We used non-invasive three-dimensional micro-computed tomography to scan twenty human femoral bone cores before and after screw insertion. After image registration of the pre- and post-insertion scans, changes in the bone micro-architecture were identified and quantified. This procedure was performed for screws with a small thread size of 0.3mm (STS, N=10) and large thread size of 0.6mm (LTS, N=10). Most bone damage occurred within a 0.3mm radial distance of the screws. Further bone damage was observed up to 0.6mm and 0.9mm radial distance from the screw, for the STS and LTS groups, respectively. While a similar amount of bone damage was found within a 0.3mm radial distance for the two screw groups, there was significantly more bone damage for the LTS group than the STS group in volumes of interest between 0.3-0.6mm and 0.6-0.9mm. In conclusion, this is the first study to localize and quantify peri-implant bone damage caused by screw insertion based on a non-invasive, three-dimensional, micro-CT imaging technique. We demonstrated that peri-implant bone damage already occurs during screw insertion. This should be taken into consideration to further improve primary implant stability, especially in low quality osteoporotic bone. We believe that this technique could be a promising method to assess more systematically the effect of peri-implant bone damage on primary implant stability. Furthermore, including peri-implant bone damage due to screw insertion into patient-specific in silico models of implant-bone systems could improve the

  4. Distributions of Synergistetes in clinically-healthy and diseased periodontal and peri-implant niches.

    PubMed

    Yu, Xiao-Lin; Chan, Yuki; Zhuang, Long-Fei; Lai, Hong-Chang; Lang, Niklaus P; Lacap-Bugler, Donnabella C; Leung, W Keung; Watt, Rory M

    2016-05-01

    Bacterial taxa belonging to the phylum Synergistetes are commonly detected within diseased periodontal niches, but are rarely found within healthy oral sites. However, as they typically constitute a minor fraction of the oral microbiota, their precise distributions and disease-associations remain to be fully established. Here, we surveyed the Synergistetes taxa present within individual periodontal/subgingival and peri-implant/submucosal sites, within Chinese subjects (n = 18) affected by both peri-implantitis and periodontitis. Four individual, clinically-distinct sites were analyzed in each patient: healthy sulcus; periodontitis lesion; healthy peri-implant space; peri-implantitis lesion. We employed a clone library-based approach, using PCR-primers that specifically amplified ca. 650bp regions of the 16S rRNA gene from oral cluster A and B Synergistetes taxa. Twenty-one of the 72 sites (from 12/18 subjects) yielded Synergistetes 16S rRNA PCR products. Sequencing of cloned amplicon libraries yielded 1338 quality-filtered 16S rRNA sequences, which were assigned to 26 Synergistetes operational taxonomic units (OTUs; oral taxon SH01-SH26) using a 98.5% identity cut-off. We identified 25 Synergistetes oral cluster A OTUs (genus Fretibacterium; corresponding to Human Oral Taxon (HOT) numbers 358, 359, 360, 361, 362, 363, 452, and 453), and one oral cluster B OTU (Pyramidobacter piscolens oral taxon SH04, HOT-357). Three OTUs predominated: Fretibacterium oral taxon SH01 (HOT-360), Fretibacterium oral taxon SH02 (HOT-452), and Fretibacterium fastidiosum oral taxon SH03 (HOT-363). The Synergistetes community compositions within the respective periodontal and peri-implant sites were variable and complex, and no statistically-significant correlations could be established. However, the detection frequency of F. fastidiosum SH03 and Fretibacterium oral taxon SH01 were both positively associated with plaque index at healthy subgingival sites. Taken together, our results

  5. Effect of plasma-rich in platelet-derived growth factors on peri-implant bone healing: An experimental study in canines

    PubMed Central

    Birang, Reza; Torabi, Alireza; Shahabooei, Mohammad; Rismanchian, Mansour

    2012-01-01

    Background: Tissue engineering principles can be exploited to enhance alveolar and peri-implant bone reconstruction by applying such biological factors as platelet-derived growth factors. The objective of the present study is to investigate the effect of autologous plasma-rich in growth factors (on the healing of peri-implant bone in canine mandible). Materials and Methods: In this prospective experimental animal study, two healthy canines of the Iranian mix breed were selected. Three months after removing their premolar teeth on both sides of the mandible, 12 implants of the Osteo Implant Corporationsystem, 5 mm in diameter and 10 mm in length, were selected to be implanted. Plasma rich in growth factors (PRGF) were applied on six implants while the other six were used as plain implants without the plasma. The implants were installed in osteotomy sites on both sides of the mandible to be removed after 4 weeks with the surrounding bones using a trephine bur. Mesio-distal sections and implant blocks, 50 μ in diameter containing the peri-implant bone, were prepared By basic fuchin toluidine-bluefor histological and histomorphometric evaluation by optical microscope. The data were analyzed using Mann-Whitney Test (P<0.05). Results: The bone trabeculae and the type of bone generation in PRGF and control groups had no statistically significant differences (P=0.261, P=0.2) although the parameters showed higher measured values in the PRGF group. However, compared to the control, application of PRGF had significantly increased bone-to-implant contact (P=0.028) Conclusion: Based on the results, it may be concluded that application of PRGF on the surface of implant may enhance bone-to-implant contact. PMID:22363370

  6. Biological markers during early pregnancy: trophoblastic signals of the peri-implantation period.

    PubMed Central

    Glasser, S R; Julian, J; Munir, M I; Soares, M J

    1987-01-01

    The peri-implantation period extends from the time the blastocyst is free in the uterus, through the processes of recognition and attachment, to the beginning of trophoblast differentiation and the interactions between the embryo and the uterine endometrium which initiate establishment of the hemochorial placenta. It is during the peri-implantation period that the embryo and hormonally regulated endometrial cells appear to be most sensitive to factors which introduce risk into the intrauterine environment. There are no markers which can be used practically to assess pregnancy risk during the peri-implantation period of either human or laboratory rodents. Experimental studies, using in vitro laboratory models of differentiating trophoblast cells, have identified peptide hormone markers of pivotal developmental processes. Exposure of trophoblast during the expression of these processes could have severe and far-reaching effects individually and societally. While these trophoblast signals are limited in their utility with respect to health monitoring extrapolation of these findings to human pregnancy, the signals could serve to identify more practical and sensitive markers to assess risk in early gestation. Human chorionic gonadotropin (hCG) has been used extensively as a marker to assess risk during the early stages of pregnancy. Extrapolation of experimental data indicates how hCG could be used more effectively in analyses of possible cause and effect relationships. The limitations of hCG as a marker for risk during the human peri-implantation period are discussed. Peptide hormones which could serve to assess risk during this critical period of extraordinary sensitivity to toxic factors are introduced. PMID:3319548

  7. Absence of connexin43 and connexin45 does not disturb pre- and peri-implantation development.

    PubMed

    Nishii, Kiyomasa; Kobayashi, Yasushi; Shibata, Yosaburo

    2016-06-01

    Gap junctional intercellular communication is assumed to play an important role during pre- and peri-implantation development. In this study, we eliminated connexin43 (Cx43) and connexin45 (Cx45), major gap junctional proteins in the pre- and peri-implantation embryo. We generated Cx43 -/- Cx45 -/- embryos by Cx43 +/- Cx45 +/- intercrossing, because mice deficient in Cx43 (Cx43 -/-) exhibit perinatal lethality and those deficient in Cx45 (Cx45 -/-) exhibit early embryonic lethality. Wild-type, Cx43 -/-, Cx45 -/-, and Cx43 -/- Cx45 -/- blastocysts all showed similar outgrowths in in vitro culture. Moreover, Cx43 -/- Cx45 -/- embryos were obtained at the expected Mendelian ratio up to embryonic day 9.5, when the Cx45 -/- mutation proved lethal. The Cx43 -/- Cx45 -/- embryos seemed to have no additional developmental abnormalities in comparison with the single knockout strains. Thus, pre- and peri-implantation development does not require Cx43 and Cx45. Other gap junctional proteins are expressed around these stages and these may compensate for the lack of Cx43 and Cx45. PMID:27172058

  8. Skin and Soft Tissue Infections.

    PubMed

    Ramakrishnan, Kalyanakrishnan; Salinas, Robert C; Agudelo Higuita, Nelson Ivan

    2015-09-15

    Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. Management is determined by the severity and location of the infection and by patient comorbidities. Infections can be classified as simple (uncomplicated) or complicated (necrotizing or nonnecrotizing), or as suppurative or nonsuppurative. Most community-acquired infections are caused by methicillin-resistant Staphylococcus aureus and beta-hemolytic streptococcus. Simple infections are usually monomicrobial and present with localized clinical findings. In contrast, complicated infections can be mono- or polymicrobial and may present with systemic inflammatory response syndrome. The diagnosis is based on clinical evaluation. Laboratory testing may be required to confirm an uncertain diagnosis, evaluate for deep infections or sepsis, determine the need for inpatient care, and evaluate and treat comorbidities. Initial antimicrobial choice is empiric, and in simple infections should cover Staphylococcus and Streptococcus species. Patients with complicated infections, including suspected necrotizing fasciitis and gangrene, require empiric polymicrobial antibiotic coverage, inpatient treatment, and surgical consultation for debridement. Superficial and small abscesses respond well to drainage and seldom require antibiotics. Immunocompromised patients require early treatment and antimicrobial coverage for possible atypical organisms. PMID:26371732

  9. Injectable fillers for facial soft tissue enhancement.

    PubMed

    Sclafani, A P; Romo, T

    2000-01-01

    Soft tissue augmentation materials have been advocated for correction of post-surgical or post-traumatic facial defects, as well as for age-related folds and wrinkles. While autogenous tissues may be the safest option, they require a second operative site. Animal-derived or synthetic materials have been advocated since the late 19th century, and have waxed and waned in popularity. In recent years, we have gained a better understanding of the physical events that occur when material is placed within or below the skin. With this knowledge, we stand at the threshold of a new era, where soft tissue fillers can be designed and customized to suit the individual patient. This article will review the major materials that have been or are now advocated for use as soft tissue fillers, and will detail their relative strengths and weaknesses in order to give the clinician a better perspective when considering a material for soft tissue augmentation. PMID:11802343

  10. Malignant soft tissue tumors in children.

    PubMed

    Thacker, Mihir M

    2013-10-01

    Soft tissue masses are frequently seen in children. Although most are benign or reactive, soft tissue sarcomas (STS)-both rhabdomyosarcoma (most common) and non-rhabdo STS, do occur in the extremities. Appropriate evaluation of extremity soft tissue tumors often includes a biopsy as the clinical and imaging features may not be enough to establish a definitive diagnosis. Much needs to be done for improving the treatment of these rare but often devastating sarcomas. Given the small numbers of these cases seen at various centers, collaborative efforts should be made to further our understanding and improve the management of these challenging cases. PMID:24095080

  11. New Soft Tissue Implants Using Organic Elastomers

    NASA Astrophysics Data System (ADS)

    Ku, David N.

    Typical biomaterials are stiff, difficult to manufacture, and not initially developed for medical implants. A new biomaterial is proposed that is similar to human soft tissue. The biomaterial provides mechanical properties similar to soft tissue in its mechanical and physical properties. Characterization is performed for modulus of elasticity, ultimate strength and wear resistance. The material further exhibits excellent biocompatibility with little toxicity and low inflammation. The material can be molded into a variety of anatomic shapes for use as a cartilage replacement, heart valve, and reconstructive implant for trauma victims. The biomaterial may be suitable for several biodevices of the future aimed at soft-tissue replacements.

  12. Chondro-Osseous Lesions of Soft Tissue.

    PubMed

    Cho, Soo-Jin; Horvai, Andrew

    2015-09-01

    Soft tissue lesions can contain bone or cartilage matrix as an incidental, often metaplastic, phenomenon or as a diagnostic feature. The latter category includes a diverse group ranging from self-limited proliferations to benign neoplasms to aggressive malignancies. Correlating imaging findings with pathology is mandatory to confirm that a tumor producing bone or cartilage, in fact, originates from soft tissue rather than from the skeleton. The distinction can have dramatic diagnostic and therapeutic implications. This content focuses on the gross, histologic, radiographic, and clinical features of bone or cartilage-producing soft tissue lesions. Recent discoveries regarding tumor-specific genetics are discussed. PMID:26297064

  13. Soft tissue balancing in total knee arthroplasty

    PubMed Central

    MELONI, MARIA CHIARA; HOEDEMAEKER, RUSSALKA W.; VIOLANTE, BRUNO; MAZZOLA, CLAUDIO

    2014-01-01

    A good outcome in total knee arthroplasty depends on many factors: joint alignment, range of motion, patellar tracking and ligament stability. A correct soft tissue balance keeps the joint aligned in flexion and extension, and therefore constitutes the most important factor for durability of the implant. Indeed, incorrect soft tissue balancing is the primary cause of early implant failure necessitating revision surgery. Soft tissue releases, serving to correct imbalances, are performed until the flexion and extension gaps appear symmetrical and balanced. A knee is considered perfectly balanced when the flexion and extension gaps are perfectly rectangular and all the measurements are absolutely equal. PMID:25606540

  14. Raman Spectroscopy of Soft Musculoskeletal Tissues

    PubMed Central

    Esmonde-White, Karen

    2015-01-01

    Tendon, ligament, and joint tissues are important in maintaining daily function. They can be affected by disease, age, and injury. Slow tissue turnover, hierarchical structure and function, and nonlinear mechanical properties present challenges to diagnosing and treating soft musculoskeletal tissues. Understanding these tissues in health, disease, and injury is important to improving pharmacologic and surgical repair outcomes. Raman spectroscopy is an important tool in the examination of soft musculoskeletal tissues. This article highlights exciting basic science and clinical/translational Raman studies of cartilage, tendon, and ligament. PMID:25286106

  15. Implant Materials Generate Different Peri-implant Inflammatory Factors

    PubMed Central

    Olivares-Navarrete, Rene; Hyzy, Sharon L.; Slosar, Paul J.; Schneider, Jennifer M.; Schwartz, Zvi

    2015-01-01

    Study Design. An in vitro study examining factors produced by human mesenchymal stem cells on spine implant materials. Objective. The aim of this study was to examine whether the inflammatory microenvironment generated by cells on titanium-aluminum-vanadium (Ti-alloy, TiAlV) surfaces is affected by surface microtexture and whether it differs from that generated on poly-ether-ether-ketone (PEEK). Summary of Background Data. Histologically, implants fabricated from PEEK have a fibrous connective tissue surface interface whereas Ti-alloy implants demonstrate close approximation with surrounding bone. Ti-alloy surfaces with complex micron/submicron scale roughness promote osteoblastic differentiation and foster a specific cellular environment that favors bone formation whereas PEEK favors fibrous tissue formation. Methods. Human mesenchymal stem cells were cultured on tissue culture polystyrene, PEEK, smooth TiAlV, or macro-/micro-/nano-textured rough TiAlV (mmnTiAlV) disks. Osteoblastic differentiation and secreted inflammatory interleukins were assessed after 7 days. Fold changes in mRNAs for inflammation, necrosis, DNA damage, or apoptosis with respect to tissue culture polystyrene were measured by low-density polymerase chain reaction array. Data were analyzed by analysis of variance, followed by Bonferroni's correction of Student's t-test. Results. Cells on PEEK upregulated mRNAs for chemokine ligand-2, interleukin (IL) 1β, IL6, IL8, and tumor necrosis factor. Cells grown on the mmnTiAlV had an 8-fold reduction in mRNAs for toll-like receptor-4. Cells grown on mmnTiAlV had reduced levels of proinflammatory interleukins. Cells on PEEK had higher mRNAs for factors strongly associated with cell death/apoptosis, whereas cells on mmnTiAlV exhibited reduced cytokine factor levels. All results were significant (P < 0.05). Conclusion. These results suggest that fibrous tissue around PEEK implants may be due to several factors: reduced osteoblastic differentiation of

  16. Soft Tissue Sarcomas and Agent Orange

    MedlinePlus

    ... survivors' benefits . Research on soft tissue sarcoma and herbicides The Health and Medicine Division (formally known as ... report " Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam " and other updates that there ...

  17. Local Recurrence of Extremity Soft Tissue Sarcoma.

    PubMed

    Guerrero, Whitney M; Deneve, Jeremiah L

    2016-10-01

    The management of recurrent soft tissue sarcoma is a challenging problem for clinicians and has a significant physical, mental, emotional, and oncologic impact for the patient. Despite excellent limb-preservation therapies, approximately one-quarter of patients may eventually develop recurrence of disease. How to most appropriately manage these patients is a matter of debate. Several treatment options exist, including surgical resection, irradiation, systemic chemotherapy, amputation, and regional therapies. This article highlights the management of recurrent extremity soft tissue sarcoma. PMID:27542648

  18. Injectable Silk Foams for Soft Tissue Regeneration

    PubMed Central

    Bellas, E.; Lo, T.J.; Fournier, E.P.; Brown, J.E.; Abbott, R.D.; Gil, E.S.; Marra, K.G.; Rubin, J.P.; Leisk, G.G.; Kaplan, D.L.

    2015-01-01

    Soft tissue fillers are needed for restoration of a defect or augmentation of existing tissues. Autografts and lipotransfer have been under study for soft tissue reconstruction but yield inconsistent results, often with considerable resorption of the grafted tissue. A minimally invasive procedure would reduce scarring and recovery time as well as allow for the implant and/or grafted tissue to be placed closer to existing vasculature. Here, we demonstrate the feasibility of an injectable silk foam for soft tissue regeneration. Adipose derived stem cells survive and migrate through the foam over a 10 day period in vitro. The silk foams are also successfully injected into the subcutaneous space in a rat and over a 3 month period integrating with the surrounding native tissue. The injected foams are palpable and soft to the touch through the skin and returning to their original dimensions after pressure was applied and then released. The foams readily absorb lipoaspirate making the foams useful as a scaffold or template for existing soft tissue filler technologies, useful either as a biomaterial alone or in combination with the lipoaspirate. PMID:25323438

  19. Application of Proteomics to Soft Tissue Sarcomas

    PubMed Central

    Kondo, Tadashi; Kubota, Daisuke; Kawai, Akira

    2012-01-01

    Soft tissue sarcomas are rare and account for less than 1% of all malignant cancers. Other than development of intensive therapies, the clinical outcome of patients with soft tissue sarcoma remains very poor, particularly when diagnosed at a late stage. Unique mutations have been associated with certain soft tissue sarcomas, but their etiologies remain unknown. The proteome is a functional translation of a genome, which directly regulates the malignant features of tumors. Thus, proteomics is a promising approach for investigating soft tissue sarcomas. Various proteomic approaches and clinical materials have been used to address clinical and biological issues, including biomarker development, molecular target identification, and study of disease mechanisms. Several cancer-associated proteins have been identified using conventional technologies such as 2D-PAGE, mass spectrometry, and array technology. The functional backgrounds of proteins identified were assessed extensively using in vitro experiments, thus supporting expression analysis. These observations demonstrate the applicability of proteomics to soft tissue sarcoma studies. However, the sample size in each study was insufficient to allow conclusive results. Given the low frequency of soft tissue sarcomas, multi-institutional collaborations are required to validate the results of proteomic approaches. PMID:22778956

  20. Heterogeneous genetic profiles in soft tissue myoepitheliomas.

    PubMed

    Hallor, Karolin H; Teixeira, Manuel R; Fletcher, Christopher D M; Bizarro, Susana; Staaf, Johan; Domanski, Henryk A; von Steyern, Fredrik Vult; Panagopoulos, Ioannis; Mandahl, Nils; Mertens, Fredrik

    2008-11-01

    Myoepithelioma, mixed tumor and parachordoma are uncommon soft tissue tumors thought to represent morphological variants of a single tumor type. The genetic basis of these neoplasms is poorly understood. However, they morphologically resemble mixed tumor of the salivary glands (also known as pleomorphic adenoma), a tumor characterized by deregulated expression of PLAG1 or HMGA2. To evaluate a possible genetic relationship between these soft tissue and salivary gland tumors, PLAG1 expression levels and the genomic status of PLAG1 and HMGA2 were investigated in five soft tissue myoepitheliomas and one pleomorphic adenoma. In addition, all tumors were cytogenetically investigated and whole genome DNA copy number imbalances were studied in five of them. The genetic profiles were heterogeneous and the only aberration common to all soft tissue myoepitheliomas was a minimally deleted region of 3.55 Mb in chromosome band 19p13. Recurrent deletion of CDKN2A suggests that inactivation of this tumor suppressor gene is pathogenetically important in a subset. Furthermore, PLAG1 rearrangement was found in a soft tissue tumor from a patient previously treated for a salivary pleomorphic adenoma, indicating either metastasis of the salivary gland lesion or that some soft tissue tumors develop through the same mechanisms as their salivary gland counterparts. PMID:18604193

  1. Soft tissue engineering in craniomaxillofacial surgery

    PubMed Central

    Kim, Roderick Y; Fasi, Anthony C; Feinberg, Stephen E

    2014-01-01

    Craniofacial soft tissue reconstruction may be required following trauma, tumor resection, and to repair congenital deformities. Recent advances in the field of tissue engineering have significantly widened the reconstructive armamentarium of the surgeon. The successful identification and combination of tissue engineering, scaffold, progenitor cells, and physiologic signaling molecules has enabled the surgeon to design, recreate the missing tissue in its near natural form. This has resolved the issues like graft rejection, wound dehiscence, or poor vascularity. Successfully reconstructed tissue through soft tissue engineering protocols would help surgeon to restore the form and function of the lost tissue in its originality. This manuscript intends to provide a glimpse of the basic principle of tissue engineering, contemporary, and future direction of this field as applied to craniofacial surgery. PMID:24987591

  2. Comparative volumetric and clinical evaluation of peri-implant sulcular fluid and gingival crevicular fluid

    PubMed Central

    Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

    2013-01-01

    Purpose Peri-implant sulcular fluid (PISF) has a production mechanism similar to gingival crevicular fluid (GCF). However, limited research has been performed comparing their behavior in response to inflammation. Hence, the aim of the present study was to comparatively evaluate PISF and GCF volume with varying degrees of clinical inflammatory parameters. Methods Screening of patients was conducted. Based on the perimucosal inflammatory status, 39 loaded implant sites were selected from 24 patients, with equal numbers of sites in healthy, peri-implant mucositis, and peri-implantitis subgroups. GCF collection was done from age- and sex-matched dentate patients, selected with gingival inflammatory status corresponding to the implant sites. Assessment of the inflammatory status for dental/implant sites was performed using probing depth (PD), plaque index/modified plaque index (PI/mPI), gingival index/simplified gingival index (GI/sGI), and modified sulcular bleeding index (BI). Sample collection was done using standardized absorbent paper strips with volumetric evaluation performed via an electronic volume quantification device. Results Positive correlation of the PISF and GCF volume was seen with increasing PD and clinical inflammatory parameters. A higher correlation of GCF with PD (0.843) was found when compared to PISF (0.771). PISF expressed a higher covariation with increasing grades of sGI (0.885), BI (0.841), and mPI (0.734), while GCF established a moderately positive correlation with GI (0.694), BI (0.696), and PI (0.729). Conclusions Within the limitations of this study, except for minor fluctuations, GCF and PISF volumes demonstrated a similar nature and volumetric pattern through increasing grades of inflammation, with PISF showing better correlation with the clinical parameters. PMID:24236246

  3. Diagnostic Accuracy of Inverted and Unprocessed Digitized Periapical Radiographs for Detection of Peri-Implant Defects

    PubMed Central

    Pourhashemi, Seyed Jalal; Kiani, Mohammad Taghi; Emami, Raheleh; Kharazifard, Mohamad Javad

    2015-01-01

    Objectives: This study aimed to compare the diagnostic accuracy of inverted and unprocessed digitized periapical radiographs for detection of peri-implant defects. Materials and Methods: A total of 30 osteotomy sites were prepared in three groups of control, study group 1 with 0.425 mm defects and study group 2 with 0.725 mm defects using the SIC and Astra Tech drill systems with 4.25mm and 4.85mm diameters. Small and large defects were randomly created in the coronal 8mm of 20 implant sites; implants (3.4mm diameter, 14.5mm length) were then placed. Thirty periapical (PA) radiographs were obtained using Digora imaging system (Soredex Corporation, Helsinki, Finland), size 2 photostimulable storage phosphor (PSP) plate sensors (40.0mm×30.0mm) and Scanora software. Unprocessed images were inverted using Scanora software by applying image inversion and a total of 60 images were obtained and randomly evaluated by four oral and maxillofacial radiologists. Data were analyzed using the t-test. Results: Significant differences were observed in absolute and complete sensitivity and specificity of the two imaging modalities for detection of small and large defects (P<0.05). Unprocessed digital images had a higher mean in terms of absolute sensitivity for detection of small defects, complete sensitivity for detection of large peri-implant defects and definite rule out of defects compared with inverted images. Conclusion: Unprocessed digital images have a higher diagnostic value for detection of small and large peri-implant defects and also for definite rule out of defects compared with inverted images. PMID:27123016

  4. Effect of the secretions from the IUD-bearing uterus on peri-implantation mouse embryos.

    PubMed

    Takeuchi, K; Mori, A; Yamamoto, S; Sonoda, T; Nagata, Y

    1990-06-01

    This study was performed to evaluate the effect of IUD-bearing uterine secretions on peri-implantation mouse embryo. 83% of blastocysts degenerated by 96 hr after co-culture with uterine fluids from the IUD-bearing uterus. This degeneration rate was contrasted to 78% after heat treatment (56 degrees C for 30 min) of the IUD-bearing uterine secretions. These results suggest that embryotoxic agents are present in the fluid of the IUD-bearing uterus, especially in the supernatant component and that these agents may be related to the presence of macrophage or a chemical mediator produced by macrophage. PMID:2361372

  5. Squamous cell carcinoma presenting as peri-implantitis: a case report.

    PubMed

    Gulati, Aakshay; Puthussery, Francy J; Downie, Ian P; Flood, Timothy R

    2009-10-01

    Dental implants have proved to be a useful adjunct in the rehabilitation of oral cancer patients. We describe the case of a 62-year-old woman who presented with a white patch in the oral cavity, diagnosed to be a squamous cell carcinoma. She underwent extensive surgery including microvascular reconstruction, followed by implant rehabilitation. Unfortunately, she suffered from multiple episodes of peri-implantitis and later on went on to develop oral squamous cell carcinoma around two of the dental implants. Here, we highlight the importance of regular follow-up and maintaining a high index of suspicion in high-risk patients. PMID:19833011

  6. Transcriptomic analysis of the myometrium during peri-implantation period and luteolysis--the study on the pig model.

    PubMed

    Franczak, Anita; Wojciechowicz, Bartosz; Kolakowska, Justyna; Zglejc, Kamila; Kotwica, Genowefa

    2014-12-01

    In pigs, implantation begins with the attachment of embryos to the endometrium. As the process is regulated by the expression of numerous genes, endometrial transcriptomic profiles have been extensively studied in early gravid pigs. However, the myometrium, a secretory tissue, should not be neglected, as it can also participate in the regulation of implantation in early pregnant pigs. To clarify this issue, the transcriptomic profile of the porcine myometrium during the peri-implantation period (i.e. on days 15 to 16 of pregnancy) was compared with the profile observed during luteolysis (i.e. on days 15 to 16 of the oestrous cycle) with an Agilent's Porcine (V2) Two-Colour Gene Expression Microarray 4 × 44 (Agilent, USA). Analysis of the microarray data revealed that of 526 unique, accurately annotated genes, the expression of 271 unique genes was upregulated, while the expression of 255 genes was downregulated in pregnant versus cyclic myometrium. The in-depth data analysis revealed differential expression of genes encoding for factors involved in immunomodulation, tissue growth and differentiation, and prostaglandin and steroid biosynthesis and action. Moreover, the comparison of the obtained data on the myometrial transcriptome with our previously published results on the endometrial transcriptome allowed us to determine substantial differences in the regulatory function of both tissues. The new insights into the function of the myometrium of early pregnant pigs obtained here are in agreement with our previous results that suggest that this tissue plays an important role in providing optimal conditions for developing embryos. Therefore, the importance of the myometrium as an active embryo signal-responsive tissue during early pregnancy cannot be underestimated. PMID:25240502

  7. Does the number of implants have any relation with peri-implant disease?

    PubMed Central

    PASSONI, Bernardo Born; DALAGO, Haline Renata; SCHULDT FILHO, Guenther; OLIVEIRA DE SOUZA, João Gustavo; BENFATTI, César Augusto Magalhães; MAGINI, Ricardo de Souza; BIANCHINI, Marco Aurélio

    2014-01-01

    Objective The aim of this study was to evaluate the relationship between the number of pillar implants of implant-supported fixed prostheses and the prevalence of periimplant disease. Material and Methods Clinical and radiographic data were obtained for the evaluation. The sample consisted of 32 patients with implant-supported fixed prostheses in function for at least one year. A total of 161 implants were evaluated. Two groups were formed according to the number of implants: G1) ≤5 implants and G2) >5 implants. Data collection included modified plaque index (MPi), bleeding on probing (BOP), probing depth (PD), width of keratinized mucosa (KM) and radiographic bone loss (BL). Clinical and radiographic data were grouped for each implant in order to conduct the diagnosis of mucositis or peri-implantitis. Results Clinical parameters were compared between groups using Student's t test for numeric variables (KM, PD and BL) and Mann-Whitney test for categorical variables (MPi and BOP). KM and BL showed statistically significant differences between both groups (p<0.001). Implants from G1 – 19 (20.43%) – compared with G2 – 26 (38.24%) – showed statistically significant differences regarding the prevalence of peri-implantitis (p=0.0210). Conclusion It seems that more than 5 implants in total fixed rehabilitations increase bone loss and consequently the prevalence of implants with periimplantitis. Notwithstanding, the number of implants does not have any influence on the prevalence of mucositis. PMID:25466474

  8. Antibacterial properties of metal and metalloid ions in chronic periodontitis and peri-implantitis therapy.

    PubMed

    Goudouri, Ourania-Menti; Kontonasaki, Eleana; Lohbauer, Ulrich; Boccaccini, Aldo R

    2014-08-01

    Periodontal diseases like periodontitis and peri-implantitis have been linked with Gram-negative anaerobes. The incorporation of various chemotherapeutic agents, including metal ions, into several materials and devices has been extensively studied against periodontal bacteria, and materials doped with metal ions have been proposed for the treatment of periodontal and peri-implant diseases. The aim of this review is to discuss the effectiveness of materials doped with metal and metalloid ions already used in the treatment of periodontal diseases, as well as the potential use of alternative materials that are currently available for other applications but have been proved to be cytotoxic to the specific periodontal pathogens. The sources of this review included English articles using Google Scholar™, ScienceDirect, Scopus and PubMed. Search terms included the combinations of the descriptors "disease", "ionic species" and "bacterium". Articles that discuss the biocidal properties of materials doped with metal and metalloid ions against the specific periodontal bacteria were included. The articles were independently extracted by two authors using predefined data fields. The evaluation of resources was based on the quality of the content and the relevance to the topic, which was evaluated by the ionic species and the bacteria used in the study, while the final application was not considered as relevant. The present review summarizes the extensive previous and current research efforts concerning the use of metal ions in periodontal diseases therapy, while it points out the challenges and opportunities lying ahead. PMID:24704700

  9. Suture materials affect peri-implant bone healing and implant osseointegration.

    PubMed

    Villa, Oscar; Lyngstadaas, Staale P; Monjo, Marta; Satué, Maria; Rønold, Hans J; Petzold, Christiane; Wohlfahrt, Johan C

    2015-09-01

    The aim of this study was to evaluate the effects of the remnants of two suture materials on osseointegration of titanium implants in a rabbit tibial model. Calibrated defects were prepared in the tibia of five Chinchilla rabbits. Filaments of nonresorbable (NR) nylon or resorbable (R) chitosan were placed at the bone to implant interface, whereas control sites had no suture material. After a healing period of 4 weeks, a pull-out test procedure was performed followed by enzymatic analyses of the wound fluid and relative quantification of mRNA levels for bone-related and cytokine markers from the peri-implant bone. A trend toward a reduced pull-out force was observed in the NR group (NR: 23.0 ± 12.8 N; R: 33.9 ± 11.3 N; control: 33.6 ± 24.0 N). Similarly, the bone resorption marker vacuolar type H+-ATPase was increased in the NR group compared with that in the control group (P = 0.041). The R group showed trends for lower alkaline phosphatase activity and osteocalcin expression and higher total protein content and RNA compared with the control group. In this submerged healing model, peri-implant bone healing was marginally affected by the two suture materials tested. However, there was a tendency toward better osseointegration and lower expression of bone resorption markers in the R group compared with the control group. PMID:26369486

  10. Evaluation of peri-implant bone loss around platform-switched implants.

    PubMed

    Cappiello, Michele; Luongo, Roberto; Di Iorio, Donato; Bugea, Calogero; Cocchetto, Roberto; Celletti, Renato

    2008-08-01

    This clinical and radiographic prospective study evaluated bone loss around two-piece implants that were restored according to the platform-switching protocol. One hundred thirty-one implants were consecutively placed in 45 patients following a nonsubmerged surgical protocol. On 75 implants, a healing abutment 1 mm narrower than the implant platform was placed at the time of surgery. On the remaining implants, a healing abutment of the same diameter as the implant was inserted. All implants were positioned at the crestal level. Clinical and radiographic examinations were performed prior to surgery, at the end of surgery, 8 weeks after implant placement, at the time of provisional prosthesis insertion, at the time of definitive prosthesis insertion, and 12 months after loading. The data collected showed that vertical bone loss for the test cases varied between 0.6 mm and 1.2 mm (mean: 0.95 +/- 0.32 mm), while for the control cases, bone loss was between 1.3 mm and 2.1 mm (mean: 1.67 +/- 0.37 mm). These data confirm the important role of the microgap between the implant and abutment in the remodeling of the peri-implant crestal bone. Platform switching seems to reduce peri-implant crestal bone resorption and increase the long-term predictability of implant therapy. PMID:18717373

  11. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Surgical Methods

    PubMed Central

    Wilson Jr, Thomas G.

    2013-01-01

    Purpose. Peri-implantitis is one of the major causes of implant failure. The detoxification of the implant surface is necessary to obtain reosseointegration. The aim of this review was to summarize in vitro and in vivo studies as well as clinical trials that have evaluated surgical approaches for detoxification of the implant body surfaces. Materials and Methods. A literature search was conducted using MEDLINE (PubMed) from 1966 to 2013. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters, radiographic bone fill, and histological reosseointegration. Results. From 574 articles found, 76 were analyzed. The findings, advantages, and disadvantages of using mechanical, chemical methods and lasers are discussed. Conclusions. Complete elimination of the biofilms is difficult to achieve. All therapies induce changes of the chemical and physical properties of the implant surface. Partial reosseointegration after detoxification has been reported in animals. Combination protocols for surgical treatment of peri-implantitis in humans have shown some positive clinical and radiographic results, but long-term evaluation to evaluate the validity and reliability of the techniques is needed. PMID:23983691

  12. The Antimicrobial Photodynamic Therapy in the Treatment of Peri-Implantitis

    PubMed Central

    Libotte, Fabrizio; Sabatini, Silvia; Grassi, Felice Roberto

    2016-01-01

    Introduction. The aim of this study is to demonstrate the effectiveness of addition of the antimicrobial photodynamic therapy to the conventional approach in the treatment of peri-implantitis. Materials and Methods. Forty patients were randomly assigned to test or control groups. Patients were assessed at baseline and at six (T1), twelve (T2), and twenty-four (T3) weeks recording plaque index (PlI), probing pocket depth (PPD), and bleeding on probing (BOP); control group received conventional periodontal therapy, while test group received photodynamic therapy in addition to it. Result. Test group showed a 70% reduction in the plaque index values and a 60% reduction in PD values compared to the baseline. BOP and suppuration were not detectable. Control group showed a significative reduction in plaque index and PD. Discussion. Laser therapy has some advantages in comparison to traditional therapy, with faster and greater healing of the wound. Conclusion. Test group showed after 24 weeks a better value in terms of PPD, BOP, and PlI, with an average pocket depth value of 2 mm, if compared with control group (3 mm). Our results suggest that antimicrobial photodynamic therapy with diode laser and phenothiazine chloride represents a reliable adjunctive treatment to conventional therapy. Photodynamic therapy should, however, be considered a coadjuvant in the treatment of peri-implantitis associated with mechanical (scaling) and surgical (grafts) treatments. PMID:27429618

  13. In vitro antimicrobial effects of grape seed extract on peri-implantitis microflora in craniofacial implants

    PubMed Central

    Shrestha, Binit; Theerathavaj, M.L. Srithavaj; Thaweboon, Sroisiri; Thaweboon, Boonyanit

    2012-01-01

    Objective To determine the antimicrobial effects of grape seed on peri-implantitis microflora. Methods The grape seed extract was tested against peri-implantitis microflora most commonly found in craniofacial implants including reference strains of Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Candida albicans (C. albicans) and clinical strains of S. aureus, Klebsiella pneumonia (K. pneumonia) and Candida parapsilosis (C. parapsilosis) by disk diffusion test. Minimum inhibitory concentrations (MIC) and minimum cidal concentrations (MCC) were determined using modified agar dilution millpore method. The extract was further combined with polyethylene glycol and propylene glycol, and was tested for antimicrobial effects. Results Grape seed extract showed positive inhibitory effects with S. aureus at MIC of 0.625 mg/mL and MCC of 1.25 mg/mL respectively. However the extracts showed minimal or no reactivity against strains of E. coli, K. pneumonia, C. parapsilosis and C. albicans. The use of grape seed extract in combination with polyethylene glycol and propylene glycol also showed dose dependent inhibitory effect on S. aureus. Conclusions The results of the study showed that grape seed has potential antimicrobial effects which can be further studied and developed to be used in the treatment of infected skin-abutment interface of craniofacial implants. PMID:23569854

  14. Assessment of the effects of laser photobiomodulation on peri-implant bone repair through energy dispersive x-ray fluorescence: A study of dogs

    NASA Astrophysics Data System (ADS)

    Menezes, R. F.; Araújo, N. C.; Carneiro, V. S. M.; Moreno, L. M.; Guerra, L. A. P.; Santos Neto, A. P.; Gerbi, M. E. M.

    2016-03-01

    Bone neoformation is essential in the osteointegration of implants and has been correlated with the repair capacity of tissues, the blood supply and the function of the cells involved. Laser therapy accelerates the mechanical imbrication of peri-implant tissue by increasing osteoblastic activity and inducing ATP, osteopontin and the expression of sialoproteins. Objective: The aim of the present study was to assess peri-implant bone repair using the tibia of dogs that received dental implants and laser irradiation (AsGaAl 830nm - 40mW, CW, f~0.3mm) through Energy Dispersive X-ray Fluorescence (EDXRF). Methodology: Two groups were established: G1 (Control, n=20; two dental implants were made in the tibia of each animal; 10 animals); G2 (Experimental, n=20, two dental implants were made in the tibia each animal + Laser therapy; 10 animals). G2 was irradiated every 48 hours for two weeks, with a total of seven sessions. The first irradiation was conducted during the surgery, at which time a point in the surgical alveolus was irradiated prior to the placement of the implant and four new spatial positions were created to the North, South, East and West (NSEW) of the implant. The subsequent sessions involved irradiation at these four points and at one infra-implant point (in the direction of the implant apex). Each point received 4J/cm2 and a total dose of 20J/cm2 per session (treatment dose=140J/cm2). The specimens were removed 15 and 30 days after the operation for the EDXRF test. The Mann- Whitney statistical test was used to assess the results. Results: The increase in the calcium concentration in the periimplant region of the irradiated specimens (G2) was statistically significant (p < 0.05), when compared with the control group (G1). Conclusion: The results of the present study show that irradiation with the AsGaAl laser promoted an acceleration in bone repair in the peri-implant region.

  15. [Soft tissue sarcomas and gastrointestinal stromal tumors].

    PubMed

    Reichardt, P

    2016-03-01

    Soft tissue sarcomas are rare tumors that represent a major challenge due to varying clinical presentations and often interdisciplinary treatment concepts. Gold standard for the treatment of localized resectable soft tissue sarcomas is complete surgical removal. In metastatic soft tissue sarcoma, systemic therapy is the treatment of choice. The most active drugs are anthracyclines and ifosfamide. Combination chemotherapy has improved both response rate and progression-free survival at the cost of increased toxicity. Imatinib at a dose of 400 mg/day is the gold standard for patients with advanced or metastatic gastrointestinal stromal tumors (GIST). In patients with a mutation in KIT exon 9, 800 mg/day is the recommended dose. In imatinib refractory or intolerant patients, sunitinib is recommended. Regorafenib has been approved for third-line therapy. PMID:26907871

  16. Adjuvant radiation for soft tissue sarcomas.

    PubMed

    Dickie, Colleen I; Haas, Rick; O'Sullivan, Brian

    2015-01-01

    Over recent decades, limb-preservation surgery in combination with radiotherapy achieves local control rates exceeding 90% for extremity soft tissue sarcoma (STS). Local control is not as successful for retroperitoneal sarcoma (approximately 60%) despite aggressive surgical approaches including en bloc resection of uninvolved adjacent organs combined with intensity modulated radiotherapy (IMRT). This review will discuss the indications for adjuvant radiation therapy (RT) for primary presentation of soft tissue sarcoma: "What," referring to the type and manner of planning and delivery of RT; "When," referring to the timing and scheduling of RT; and "Why," referring to the rationale for the use of RT will be addressed. From a practical stand point, this Educational Chapter on "adjuvant RT" will focus on pre- and postoperative RT in the context of gross total resection for extremity and retroperitoneal soft tissue sarcoma, the two most frequent paradigms for the use of adjuvant RT. PMID:25993234

  17. Phase contrast imaging of cochlear soft tissue.

    SciTech Connect

    Smith, S.; Hwang, M.; Rau, C.; Fishman, A.; Lee, W.; Richter, C.

    2011-01-01

    A noninvasive technique to image soft tissue could expedite diagnosis and disease management in the auditory system. We propose inline phase contrast imaging with hard X-rays as a novel method that overcomes the limitations of conventional absorption radiography for imaging soft tissue. In this study, phase contrast imaging of mouse cochleae was performed at the Argonne National Laboratory Advanced Photon Source. The phase contrast tomographic reconstructions show soft tissue structures of the cochlea, including the inner pillar cells, the inner spiral sulcus, the tectorial membrane, the basilar membrane, and the Reissner's membrane. The results suggest that phase contrast X-ray imaging and tomographic techniques hold promise to noninvasively image cochlear structures at an unprecedented cellular level.

  18. [Adjuvant chemotherapy of adults soft tissue sarcomas].

    PubMed

    Bui-Nguyen, B; Italiano, A; Delva, F; Toulmond, M

    2010-06-01

    The main progress in the management of soft tissue sarcomas have been obtained in the field of local control. Although the main evolutive, vital, risk of these diseases is metastatic dissemination, efficacy of adjuvant chemotherapy remains a controversial issue. Thus, adjuvant chemotherapy cannot be considered as a standard for any situation. The last results of clinical trials, meta-analysis and population studies are presented and discussed in this article. New therapeutic strategies are to be developed to prevent metastases in soft tissue sarcomas. This needs a better understanding of the biology of those tumors, of metastases risk factors and of the determinants of systemic therapies efficacy in these tumors. PMID:20547481

  19. Systemic Therapy for Advanced Soft Tissue Sarcoma.

    PubMed

    Sheng, Jennifer Y; Movva, Sujana

    2016-10-01

    Soft tissue sarcomas are rare tumors that present with distant metastasis in up to 10% of patients. Survival has improved significantly because of advancements in histologic classification and improved management approaches. Older agents such as doxorubicin, ifosfamide, gemcitabine, and paclitaxel continue to demonstrate objective response rates from 18% to 25%. Newer agents such as trabectedin, eribulin, aldoxorubicin, and olaratumab have demonstrated improvements in progression-free survival, overall survival, or toxicity profiles. Future studies on treatment of advanced soft tissue sarcoma will continue to concentrate on reducing toxicity, personalization of therapy, and targeting novel pathways. PMID:27542647

  20. Necrotizing Soft Tissue Infections: Surgeon's Prospective

    PubMed Central

    Mishra, Shashi Prakash; Gupta, Sanjeev Kumar

    2013-01-01

    Necrotizing soft tissue infections (NSTIs) are fulminant infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Delay in diagnosing and treating these infections increases the risk of mortality. Early and aggressive surgical debridement with support for the failing organs significantly improves the survival. Although there are different forms of NSTIs like Fournier's gangrene or clostridial myonecrosis, the most important fact is that they share common pathophysiology and principles of treatment. The current paper summarizes the pathophysiology, clinical features, the diagnostic workup required and the treatment principles to manage these cases. PMID:24455410

  1. Soft tissue tumors of the sinonasal tract.

    PubMed

    Johncilla, Melanie; Jo, Vickie Y

    2016-03-01

    Primary soft tissue tumors arising in the sinonasal tract are rare. While many mesenchymal neoplasms have been reported in the nasal cavity, sinuses, and nasopharynx, few are distinctive to this anatomic region. Some tumor types are relatively more common in this area, such as schwannoma and rhabdomyosarcoma. Nasopharyngeal angiofibroma and sinonasal hemangiopericytoma are unique entities of the sinonasal tract, as well as the recently characterized biphenotypic sinonasal sarcoma. This review discusses the clinical, morphologic, and immunohistochemical features and currently known molecular data of the more frequently encountered soft tissue tumors of the sinonasal tract. PMID:26472693

  2. CCI-779 in Treating Patients With Soft Tissue Sarcoma or Gastrointestinal Stromal Tumor

    ClinicalTrials.gov

    2013-06-03

    Gastrointestinal Stromal Tumor; Recurrent Adult Soft Tissue Sarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  3. Soft tissue differentiation by diffuse reflectance spectroscopy

    NASA Astrophysics Data System (ADS)

    Zam, Azhar; Stelzle, Florian; Nkenke, Emeka; Tangermann-Gerk, Katja; Schmidt, Michael; Adler, Werner; Douplik, Alexandre

    2009-07-01

    Laser surgery gives the possibility to work remotely which leads to high precision, little trauma and high level sterility. However these advantages are coming with the lack of haptic feedback during the laser ablation of tissue. Therefore additional means are required to control tissue-specific ablation during laser surgery supporting the surgeon regardless of experience and skills. Diffuse Reflectance Spectroscopy provides a straightforward and simple approach for optical tissue differentiation. We measured diffuse reflectance from four various tissue types ex vivo. We applied Linear Discriminant Analysis (LDA) to differentiate the four tissue types and computed the area under the ROC curve (AUC). Special emphasis was taken on the identification of nerve as the most crucial tissue for maxillofacial surgery. The results show a promise for differentiating soft tissues as guidance for tissue-specific laser surgery by means of the diffuse reflectance.

  4. Biomimetic 3D tissue printing for soft tissue regeneration.

    PubMed

    Pati, Falguni; Ha, Dong-Heon; Jang, Jinah; Han, Hyun Ho; Rhie, Jong-Won; Cho, Dong-Woo

    2015-09-01

    Engineered adipose tissue constructs that are capable of reconstructing soft tissue with adequate volume would be worthwhile in plastic and reconstructive surgery. Tissue printing offers the possibility of fabricating anatomically relevant tissue constructs by delivering suitable matrix materials and living cells. Here, we devise a biomimetic approach for printing adipose tissue constructs employing decellularized adipose tissue (DAT) matrix bioink encapsulating human adipose tissue-derived mesenchymal stem cells (hASCs). We designed and printed precisely-defined and flexible dome-shaped structures with engineered porosity using DAT bioink that facilitated high cell viability over 2 weeks and induced expression of standard adipogenic genes without any supplemented adipogenic factors. The printed DAT constructs expressed adipogenic genes more intensely than did non-printed DAT gel. To evaluate the efficacy of our printed tissue constructs for adipose tissue regeneration, we implanted them subcutaneously in mice. The constructs did not induce chronic inflammation or cytotoxicity postimplantation, but supported positive tissue infiltration, constructive tissue remodeling, and adipose tissue formation. This study demonstrates that direct printing of spatially on-demand customized tissue analogs is a promising approach to soft tissue regeneration. PMID:26056727

  5. Equine Model for Soft Tissue Regeneration

    PubMed Central

    Moreau, J.E.; Lo, T.; Quinn, K.P.; Fourligas, N.; Georgakoudi, I.; Leisk, G.G.; Mazan, M.; Thane, K.E.; Taeymans, O.; Hoffman, A.M.; Kaplan, D. L.; Kirker-Head, C.A.

    2016-01-01

    Soft tissue regeneration methods currently yield suboptimal clinical outcomes due to loss of tissue volume and a lack of functional tissue regeneration. Grafted tissues and natural biomaterials often degrade or resorb too quickly, while most synthetic materials do not degrade. In previous research we demonstrated that soft tissue regeneration can be supported using silk porous biomaterials for at least 18 months in vivo in a rodent model. In the present study, we scaled the system to a survival study using a large animal model and demonstrated the feasibility of these biomaterials for soft tissue regeneration in adult horses. Both slow and rapidly degrading silk matrices were evaluated in subcutaneous pocket and intramuscular defect depots. We showed that we can effectively employ an equine model over six months to simultaneously evaluate many different implants, reducing the number of animals needed. Furthermore, we were able to tailor matrix degradation by varying the initial format of the implanted silk. Finally, we demonstrate ultrasound imaging of implants to be an effective means for tracking tissue regeneration and implant degradation. PMID:25350377

  6. Gingival Mesenchymal Stem Cell (GMSC) Delivery System Based on RGD-Coupled Alginate Hydrogel with Antimicrobial Properties: A Novel Treatment Modality for Peri-Implantitis

    PubMed Central

    Diniz, Ivana M. A.; Chen, Chider; Ansari, Sahar; Zadeh, Homayoun H.; Moshaverinia, Maryam; Chee, Daniel; Marques, Márcia M.; Shi, Songtao; Moshaverinia, Alireza

    2015-01-01

    Purpose Peri-implantitis is one of the most common inflammatory complications in dental implantology. Similar to periodontitis, in peri-implantitis, destructive inflammatory changes take place in the tissues surrounding a dental implant. Bacterial flora at the failing implant sites resemble the pathogens in periodontal disease and consist of Gram-negative anaerobic bacteria including Aggregatibacter actinomycetemcomitans (Aa). Here we demonstrate the effectiveness of a silver lactate (SL)-containing RGD-coupled alginate hydrogel scaffold as a promising stem cell delivery vehicle with antimicrobial properties. Materials and Methods Gingival mesenchymal stem cells (GMSCs) or human bone marrow mesenchymal stem cells (hBMMSCs) were encapsulated in SL-loaded alginate hydrogel microspheres. Stem cell viability, proliferation, and osteo-differentiation capacity were analyzed. Results Our results showed that SL exhibited antimicrobial properties against Aa in a dose-dependent manner, with 0.50 mg/ml showing the greatest antimicrobial properties while still maintaining cell viability. At this concentration, SL-containing alginate hydrogel was able to inhibit Aa on the surface of Ti discs and significantly reduce the bacterial load in Aa suspensions. Silver ions were effectively released from the SL-loaded alginate microspheres for up to 2 weeks. Osteogenic differentiation of GMSCs and hBMMSCs encapsulated in the SL-loaded alginate microspheres were confirmed by the intense mineral matrix deposition and high expression of osteogenesis-related genes. Conclusion Taken together, our findings confirm that GMSCs encapsulated in RGD-modified alginate hydrogel containing SL show promise for bone tissue engineering with antimicrobial properties against Aa bacteria in vitro. PMID:26216081

  7. Soft tissue calcification in chronic dialysis patients.

    PubMed Central

    Kuzela, D. C.; Huffer, W. E.; Conger, J. D.; Winter, S. D.; Hammond, W. S.

    1977-01-01

    Autopsy protocols and microscopic slides of 56 dialyzed and 18 nondialyzed chronically uremic patients were reviewed to assess the presence, extent, and severity of extraosseous soft tissue calcification. Calcification was identified in 79% of the dialysis patients and 44% of the nondialysis patients (P iss less than .025). Soft tissue calcification most frequently involved the heart, lungs, stomach, and kidneys. Lesions were severe in 36% of the dialysis patients and, when strategically located within the myocardium, were life-threatening. The deaths of 6 dialysis patients were attributed to severe calcification of the cardiac conduction system and/or myocardium. The presence and severity of soft tissue calcification was not related to duration of dialysis, patients' age, degree of parathyroid gland hyperplasia, radiographic evidence of soft tissue calcification, serum calcium and phosphate levels, Ca X P products, or type or severity of metabolic bone disease. Images Figure 7 Figure 8 Figure 9 Figure 10 Figure 1 Figure 2 Figure 11 Figure 12 Figure 3 Figure 4 Figure 5 Figure 6 PMID:836675

  8. Molecular Genetics of Pediatric Soft Tissue Tumors

    PubMed Central

    Chang, Chung-Che; Shidham, Vinod B.

    2003-01-01

    The application of molecular genetics to pediatric soft tissue tumors has grown tremendously over the last decade. It has resulted in the identification of novel genes that have provided us with an increased understanding of oncogenesis. Furthermore, these findings have identified diagnostic and potentially prognostic factors for patient management. Molecular diagnostic techniques, such as reverse transcription PCR (RT-PCR) and fluorescence in situ hybridization (FISH), have become important tools for evaluating pediatric soft tissue tumors. By detecting characteristic fusion genes, these techniques have greatly increased the diagnostic accuracy of histopathological classification. One of the exciting promises of the development of these molecular techniques is their ability to detect micrometastasis and minimal residual disease. Monitoring of minimal residual disease in pediatric soft tissue tumors by quantitative RT-PCR may provide important prognostic information. Furthermore, the potential development of targeted therapy based on the understanding of the molecular pathology of a specific soft tissue tumor may complement existing treatments and improve disease outcome. PMID:12876204

  9. Lasers in soft tissue dental surgery

    NASA Astrophysics Data System (ADS)

    Pick, Robert M.

    1990-06-01

    In the field of periodontics and oral surgery, the laser is a relatively new, but rapidly emerging, surgical tool. In the new area of soft tissue surgery, i.e., benign lesion and growths, the laser can completely replace the scalpel and offer the periodontist and the oral and maxillofacial surgeon a new and exciting alternative.

  10. Determination of allelic expression of h19 in pre- and peri-implantation mouse embryos.

    PubMed

    Negrón-Pérez, Verónica M; Echevarría, Franklin D; Huffman, Sarah R; Rivera, Rocío Melissa

    2013-04-01

    H19 is a maternally expressed, imprinted, noncoding RNA with tumor-suppressor activity. During mouse preimplantation development, H19 is primarily expressed in the trophectoderm cells. The purpose of this project was to determine allelic expression of H19 in pre- and peri-implantation mouse embryos. We were further interested in determining if loss of imprinted H19 expression during blastocyst development occurred as a result of superovulation and/or culture. Our last goal was to ascertain if differential H19 allelic expression occurred between the inner cell mass (ICM)-containing half and the primary trophoblast giant cell (PTGC)-containing half of the embryo. C57BL/6J((Cast-7))xC57BL/6J F1 embryos were collected from the uterus at 84, 96, and 108 h following natural ovulation or superovulation. In vitro-cultured F1 embryos were harvested from the oviduct at the 2-cell stage and cultured in KSOM + aa supplemented with amino acids or Whitten media and collected at the above-mentioned times. Allele-specific H19 expression in single embryos was determined by qRT-PCR followed by fluorescence resonance electron transfer or RT-PCR followed by restriction fragment length polymorphism and polyacrylamide gel electrophoresis (RFLP-PAGE). Peri-implantation embryos were microdissected into two sections, one containing the ICM and the other containing the PTGC. TaqMan probes for Dek, Pou5f1, Itga7, H19, and Igf2 were used to ascertain gene expression enrichment in each section. Allele-specific H19 expression in embryo sections was determined by RFLP-PAGE. We found that as embryos advance through preimplantation development they start expressing H19 in a biallelic manner and this phenomenon was observed in the cultured and the in vivo-developed embryos. The PTGC-containing half of the embryo had greater expression of H19 when compared to the ICM-containing half of the embryo, as determined by qRT-PCR. In conclusion, loss of imprinting of H19 occurs in the PTGC

  11. Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis.

    PubMed

    Monje, A; Aranda, L; Diaz, K T; Alarcón, M A; Bagramian, R A; Wang, H L; Catena, A

    2016-04-01

    At the present time, peri-implantitis has become a global burden that occurs with a frequency from 1% to 47% at implant level. Therefore, we aimed herein at assessing the impact of peri-implant maintenance therapy (PIMT) on the prevention of peri-implant diseases. Electronic and manual literature searches were conducted by 3 independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles up to June 2015 without language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of peri-implant diseases under a strict regime or not of PIMT. Implant survival and failure rate were studied as secondary outcomes. A meta-analysis was conducted to evaluate the influence of PIMT and other reported variables upon peri-implant diseases. Thirteen and 10 clinical trials were included in the qualitative and quantitative analysis, respectively. Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. Similarly, significant effects of history of periodontal disease were obtained for peri-implantitis for both implant and patient levels. Furthermore, mean PIMT interval was demonstrated to influence the incidence of peri-implantitis at implant but not patient level. PIMT interval showed significance at both levels. For implant survival, implants under PIMT have 0.958 the incident event than those with no PIMT. Within the limitations of the present systematic review, it can be concluded that implant therapy must not be limited to the placement and restoration of dental implants but to the implementation of PIMT to potentially prevent biologic complications and hence to heighten the long-term success rate. Although it must be tailored to a patient's risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of 5 to 6 mo. Additionally, it must be

  12. Multiscale mechanical modeling of soft biological tissues

    NASA Astrophysics Data System (ADS)

    Stylianopoulos, Triantafyllos

    2008-10-01

    Soft biological tissues include both native and artificial tissues. In the human body, tissues like the articular cartilage, arterial wall, and heart valve leaflets are examples of structures composed of an underlying network of collagen fibers, cells, proteins and molecules. Artificial tissues are less complex than native tissues and mainly consist of a fiber polymer network with the intent of replacing lost or damaged tissue. Understanding of the mechanical function of these materials is essential for many clinical treatments (e.g. arterial clamping, angioplasty), diseases (e.g. arteriosclerosis) and tissue engineering applications (e.g. engineered blood vessels or heart valves). This thesis presents the derivation and application of a multiscale methodology to describe the macroscopic mechanical function of soft biological tissues incorporating directly their structural architecture. The model, which is based on volume averaging theory, accounts for structural parameters such as the network volume fraction and orientation, the realignment of the fibers in response to strain, the interactions among the fibers and the interactions between the fibers and the interstitial fluid in order to predict the overall tissue behavior. Therefore, instead of using a constitutive equation to relate strain to stress, the tissue microstructure is modeled within a representative volume element (RVE) and the macroscopic response at any point in the tissue is determined by solving a micromechanics problem in the RVE. The model was applied successfully to acellular collagen gels, native blood vessels, and electrospun polyurethane scaffolds and provided accurate predictions for permeability calculations in isotropic and oriented fiber networks. The agreement of model predictions with experimentally determined mechanical properties provided insights into the mechanics of tissues and tissue constructs, while discrepancies revealed limitations of the model framework.

  13. A positive correlation between occlusal trauma and peri-implant bone loss: literature support.

    PubMed

    Misch, Carl E; Suzuki, Jon B; Misch-Dietsh, Francine M; Bidez, Martha W

    2005-06-01

    The relationship between occlusal overload and peri-implant bone loss remains a controversial topic in implant dentistry. A causal relationship between the incidence of marginal bone loss next to an implant and occlusal overload implies a treatment plan and occlusal scheme would benefit from a force management approach. A MEDLINE-assisted and hand search of peer-reviewed English literature and relative textbooks were used for a selective review of articles addressing biomechanical stress and bone loss in cellular biomechanics, engineering principles, mechanical properties of bone, animal studies, clinical reports, bone physiology, and implant design biomechanics. These papers demonstrate occlusal overload on implants may increase the incidence of marginal bone loss. PMID:15968181

  14. Peri-Implantation Hormonal Milieu: Elucidating Mechanisms of Adverse Neurodevelopmental Outcomes.

    PubMed

    Mainigi, Monica; Rosenzweig, Jason M; Lei, Jun; Mensah, Virginia; Thomaier, Lauren; Talbot, C Conover; Olalere, Devvora; Ord, Teri; Rozzah, Rayyan; Johnston, Michael V; Burd, Irina

    2016-06-01

    While live births resulting from assisted reproductive technology (ART) exceed 1% of total births annually, the effect of ART on fetal development is not well understood. Data have demonstrated that IVF leads to alterations in DNA methylation and gene expression in the placenta that may have long-term effects on health and disease. Studies have linked adverse neurodevelopmental outcomes to ART, although human studies are inconclusive. In order to isolate the peri-implantation environment and its effects on brain development, we utilized a mouse model with and without superovulation and examined the effect of adult behavior as well as adult cortical neuronal density. Adult offspring of superovulated dams showed increased anxiety-like behavior compared to offspring of naturally mated dams (P < .05). There was no difference in memory and learning tests between the 2 groups. The adult brains from offspring of superovulated recipients had fewer neurons per field compared to naturally mated control offspring (P < .05). In order to examine potential pathways leading to these changes, we measured messenger RNA and microRNA (miRNA) expression in fetal brains at E18.5. Microarray analysis found that miRNAs miR-122, miR-144, and miR-211, involved in regulation of neuronal migration and differentiation, were downregulated in brains of offspring exposed to a superovulated environment(P < .05). There was also altered expression of genes involved in neuronal development. These results suggest that the peri-implantation environment can affect neurodevelopment and can lead to behavioral changes in adulthood. Human studies with long-term follow-up of children from ART are necessary to further investigate the influence of ART on the offspring. PMID:26614264

  15. Effect of high ovarian response on the expression of endocrine gland-derived vascular endothelial growth factor (EG-VEGF) in peri-implantation endometrium in IVF women

    PubMed Central

    Xu, Li-Zhen; Gao, Min-Zhi; Yao, Li-Hua; Liang, A-Juan; Zhao, Xiao-Ming; Sun, Zhao-Gui

    2015-01-01

    Objective: To investigate the effect of ovarian stimulation on the expression of EG-VEGF mRNA and protein in peri-implantation endometrium in women undergoing IVF and its relation with endometrial receptivity (ER). Design: Prospective laboratory study. Setting: University hospital. Patients: Eighteen women in stimulated cycles (SC) as study subjects and 18 women in natural cycles (NC) as controls. Women in SC group were classified with two subgroups, high ovarian response (SC1, n=9) with peak serum E2>5,000 pg/mL and moderate ovarian response (SC2, n=9) with peak serum E2 1,000-5,000 pg/mL. Intervention(s): Endometrial biopsies were collected 6 days after ovulation in NC or after oocyte retrieval in SC. Main outcome measure(s): Endometrium histological dating was observed with HE staining. EG-VEGF mRNA expression levels determined by real-time polymerase chain reaction analysis, and protein levels by immunohistochemistry. Results: All endometrial samples were in the secretory phase. The endometrial development in SC1 was 1 to 2 days advanced to NC, and with dyssynchrony between glandular and stromal tissue. Immunohistochemistry analysis showed that EG-VEGF protein was predominantly expressed in the glandular epithelial cells and endothelial cells of vessels, and also presented in the stroma. The image analysis confirmed that both the gland and stroma of endometrium in SC1 had a significantly lower EG-VEGF protein expression than that in SC2 and NC endometrium. Moreover, EG-VEGF mRNA levels were significantly lower in SC1 than in NC. Both EG-VEGF protein and mRNA levels had no significant difference between SC2 and NC. Conclusion: Decreased expression of EG-VEGF in the peri-implantation is associated with high ovarian response, which may account for the impaired ER and lower implantation rate in IVF cycles. PMID:26464631

  16. Peri-implant crevicular fluid levels of cathepsin-K, RANKL, and OPG around standard, short, and mini dental implants after prosthodontic loading

    PubMed Central

    Marakoğlu, İsmail; Haliloğlu, Seyfullah

    2015-01-01

    Purpose Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin -K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. Methods A total of 78 non-submerged implants (Euroteknika, Aesthetica+2, Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. Results Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG: sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. Conclusions Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading. PMID:26550525

  17. Low-level laser therapy improves peri-implant bone formation: resonance frequency, electron microscopy, and stereology findings in a rabbit model.

    PubMed

    Gomes, F V; Mayer, L; Massotti, F P; Baraldi, C E; Ponzoni, D; Webber, J B B; de Oliveira, M G

    2015-02-01

    Previous studies have reported positive effects of low-level laser therapy (LLLT) on bone healing. This study evaluated the effects of LLLT on peri-implant healing in vivo. Thirty-two rabbits had their mandibular left incisors removed, followed by immediate insertion of a dental implant into the fresh socket. Animals were assigned randomly to four groups: control (non-irradiated) or LLLT at three different doses per session: 5J/cm(2), 10J/cm(2), and 20J/cm(2). A GaAlAs laser (830nm, 50mW) was applied every 48h for 13 days, starting immediately after surgery. The implant stability quotient (ISQ) was measured using resonance frequency analysis upon implant insertion and immediately after death, 30 days after the last application. Tissues were prepared for scanning electron microscopy (SEM) and stereology. Variables measured were bone-implant contact (BIC) and bone neoformation within implant threads at three different sites. The results showed better ISQ for the 20J/cm(2) group (P=0.003). BIC values were significantly higher (P<0.05) in the 20J/cm(2) group, on both SEM and stereology. Bone area values were better in the 10J/cm(2) (P=0.036) and 20J/cm(2) (P=0.016) groups compared to the control group. Under these conditions, LLLT enhanced peri-implant bone repair, improving stability, BIC, and bone neoformation. The findings support and suggest parameters for the design of clinical trials using LLLT after implant placement. PMID:25282596

  18. Clinical significance of interleukin-1 genotype in smoking patients as a predictor of peri-implantitis: A case-control study

    PubMed Central

    García-Delaney, Cristina; Sánchez-Garcés, Maria-Ángeles; Sánchez-Torres, Alba; Gay-Escoda, Cosme

    2015-01-01

    Background Interleukin-1 (IL-1) is a proinflammatory cytokine that plays an important role in the pathogenesis of periodontitis, and so it might be useful to detect high-risk cases of peri-implantitis. It has been reported that IL-1 polymorphisms and smoking habit have a synergic effect, increasing the incidence of peri-implantitis. The aim of the present study was to evaluate the relationship between IL-1 gene polymorphisms and peri-implantitis in smoking patients. Material and Methods A case-control study was performed in 27 patients with peri-implantitis and 27 patients with healthy implants. All patients included were smokers. IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C were identified by polymerase chain reaction (PCR) amplification in order to establish a relation between these variables and the presence of peri-implantitis. A bivariate analysis was performed and odds-ratio (OR) were calculated. Results The incidence of peri-implantitis was significantly higher in patients with previous history of periodontitis (p=0.024; OR=10.9). Both groups were similar regarding IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C genotypes. No increased risk in heavy smokers with IL-1 polymorphism was found. Conclusions IL-1 genotypes do not seem to be good predictors of peri-implantitis in the great majority of smoking patients. Furthermore, no synergic effect was found between IL-1 genotypes and heavy smokers. Patients with a previous history of periodontitis were more prone to peri-implantitis. Key words:Peri-implantitis, interleukin-1 genotype positive, case-control study, smoking. PMID:26449434

  19. Soft Tissue Tumours of the Retroperitoneum

    PubMed Central

    Van Roggen, J. Frans Graadt

    2000-01-01

    Purpose. This review summarizes the more prevalent soft tissue tumours arising in the retroperitoneum and highlights some recent fundamental and diagnostic developments relevant to mesenchymal tumours. Discussion. The retroperitoneum is an underestimated site for benign and malignant neoplastic disease, and represents the second most common site of origin of primary malignant soft tissue tumours (sarcomas) after the deep tissues of the lower extremity. In contrast to the predominance of benign soft tissue lesions over malignant sarcomas elsewhere, retroperitoneal mesenchymal lesions are far more likely to be malignant. The differential diagnosis is primarily with the more common lymphoproliferative and parenchymatous epithelial lesions arising in this area, and with metastatic disease from known or unknown primary sites elsewhere.The most prevalent mesenchymal tumours at this site are of a lipomatous, myogenic or neural nature.Their generally late clinical presentation and poorly accessible location provides numerous clinical challenges; optimal radiological imaging and a properly performed biopsy are essential cogs in the management route. Histopathological diagnosis may be complicated, but has been aided by developments in the fields of immunohistochemistry and tumour (cyto)genetics. Despite significant advances in oncological management protocols, the prognosis remains generally less favourable than for similar tumours at more accessible sites. PMID:18521430

  20. Supervised autonomous robotic soft tissue surgery.

    PubMed

    Shademan, Azad; Decker, Ryan S; Opfermann, Justin D; Leonard, Simon; Krieger, Axel; Kim, Peter C W

    2016-05-01

    The current paradigm of robot-assisted surgeries (RASs) depends entirely on an individual surgeon's manual capability. Autonomous robotic surgery-removing the surgeon's hands-promises enhanced efficacy, safety, and improved access to optimized surgical techniques. Surgeries involving soft tissue have not been performed autonomously because of technological limitations, including lack of vision systems that can distinguish and track the target tissues in dynamic surgical environments and lack of intelligent algorithms that can execute complex surgical tasks. We demonstrate in vivo supervised autonomous soft tissue surgery in an open surgical setting, enabled by a plenoptic three-dimensional and near-infrared fluorescent (NIRF) imaging system and an autonomous suturing algorithm. Inspired by the best human surgical practices, a computer program generates a plan to complete complex surgical tasks on deformable soft tissue, such as suturing and intestinal anastomosis. We compared metrics of anastomosis-including the consistency of suturing informed by the average suture spacing, the pressure at which the anastomosis leaked, the number of mistakes that required removing the needle from the tissue, completion time, and lumen reduction in intestinal anastomoses-between our supervised autonomous system, manual laparoscopic surgery, and clinically used RAS approaches. Despite dynamic scene changes and tissue movement during surgery, we demonstrate that the outcome of supervised autonomous procedures is superior to surgery performed by expert surgeons and RAS techniques in ex vivo porcine tissues and in living pigs. These results demonstrate the potential for autonomous robots to improve the efficacy, consistency, functional outcome, and accessibility of surgical techniques. PMID:27147588

  1. Radiation May Help After Surgery for 'Soft-Tissue' Cancers

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_158322.html Radiation May Help After Surgery for 'Soft-Tissue' Cancers ... called soft-tissue sarcomas may benefit more from radiation therapy after surgery than younger patients do, a ...

  2. What's New in Soft Tissue Sarcomas Research and Treatment?

    MedlinePlus

    ... Topic Additional resources for soft tissue sarcoma What`s new in soft tissue sarcoma research and treatment? Research ... develop. This information is already being applied to new tests to diagnose and classify sarcomas. This is ...

  3. What Are the Key Statistics about Soft Tissue Sarcoma?

    MedlinePlus

    ... for soft tissue sarcomas? What are the key statistics about soft tissue sarcomas? The American Cancer Society's ... in the United States for 2016 are (these statistics include both adults and children): About 12,310 ...

  4. Physical Agents for Soft Tissue Injury.

    PubMed

    2016-07-01

    The clinical management of soft tissue injuries of the lower limb commonly includes physical agents such as electrotherapy or ultrasound. However, the evidence about the effectiveness of physical agents varies, and their use remains controversial. A systematic review of randomized clinical trials (RCTs), published in the July 2016 issue of JOSPT, examined the benefits and safety risks of various physical agents for soft tissue injuries of the lower limb. Importantly, the review looked closely at the quality of the RCTs and focused on studies with low risk of bias. In this Perspectives for Practice, the authors explain the impact of their findings for clinicians treating patients with such musculoskeletal conditions. J Orthop Sports Phys Ther 2016;46(7):555. doi:10.2519/jospt.2016.0503. PMID:27363571

  5. Soft tissue sarcoma of the extremity.

    PubMed Central

    Cooper, T. M.; Sheehan, M.; Collins, D.; O'Connor, T. P.

    1996-01-01

    A retrospective review of 33 cases of soft tissue sarcoma of the extremity presenting over a 10 year period was undertaken. The history, patterns of referral, diagnostic investigations, procedures undertaken and outcomes were studied. We found there was a frequent delay in diagnosis and sometimes misinterpretation of biopsy specimens. Patients were seen by a variety of specialists from disciplines such as general surgery, plastic surgery, orthopaedic surgery and rheumatology. Considerable progress has been made in the treatment of soft tissue sarcomas, often allowing local control of the tumour without amputation. We believe there should be early referral of patients having these tumours to a centre where a combined multidisciplinary approach can be undertaken. PMID:8881731

  6. Fetal soft tissue examinations by microdissection.

    PubMed

    Leroy, Mariline; Jocteur-Monrozier, Audrey

    2013-01-01

    This chapter describes methods for the examination of fetal abdominal and thoracic soft tissues by microdissection on either fresh (non-rodent) or fixed (rodent) specimens in order to detect structural abnormalities. With hundreds of fetuses examined for each species (rodent and non-rodent) in regulatory reproductive toxicity assessments (ICH, http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Multidisciplinary/M3_R2/Step4/M3_R2__Guideline.pdf, 2009; ICH, http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Safety/S5_R2/Step4/S5_R2__Guideline.pdf, 2005), microdissection techniques allow a thorough and relatively rapid examination of fetuses for soft tissue abnormalities. PMID:23138910

  7. Biopsy of soft-tissue tumors.

    PubMed

    Shives, T C

    1993-04-01

    Biopsy is an integral part of the overall management of patients with soft-tissue sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc excision. There are advantages and disadvantages of each. Open biopsy requires strict adherence to a number of surgical principles. Proper execution requires determination of appropriate biopsy site, meticulous technique, and close collaboration with an experienced pathologist. Failure to adhere to these principles may result in untoward consequences for patients. PMID:8472430

  8. Fibre-Matrix Interaction in Soft Tissue

    SciTech Connect

    Guo, Zaoyang

    2010-05-21

    Although the mechanical behaviour of soft tissue has been extensively studied, the interaction between the collagen fibres and the ground matrix has not been well understood and is therefore ignored by most constitutive models of soft tissue. In this paper, the human annulus fibrosus is used as an example and the potential fibre-matrix interaction is identified by careful investigation of the experimental results of biaxial and uniaxial testing of the human annulus fibrosus. First, the uniaxial testing result of the HAF along the axial direction is analysed and it is shown that the mechanical behaviour of the ground matrix can be well simulated by the incompressible neo-Hookean model when the collagen fibres are all under contraction. If the collagen fibres are stretched, the response of the ground matrix can still be described by the incompressible neo-Hookean model, but the effective stiffness of the matrix depends on the fibre stretch ratio. This stiffness can be more than 10 times larger than the one obtained with collagen fibres under contraction. This phenomenon can only be explained by the fibre-matrix interaction. Furthermore, we find that the physical interpretation of this interaction includes the inhomogeneity of the soft tissue and the fibre orientation dispersion. The dependence of the tangent stiffness of the matrix on the first invariant of the deformation tensor can also be explained by the fibre orientation dispersion. The significant effect of the fibre-matrix interaction strain energy on mechanical behaviour of the soft tissue is also illustrated by comparing some simulation results.

  9. Imaging in Soft Tissue Sarcomas: Current Updates.

    PubMed

    Jagannathan, Jyothi P; Tirumani, Sree Harsha; Ramaiya, Nikhil H

    2016-10-01

    Soft tissue sarcomas (STS) are heterogeneous malignant tumors that have nonspecific imaging features. A combination of clinical, demographic, and imaging characteristics can aid in the diagnosis. Imaging provides important information regarding the tumor extent, pretreatment planning, and surveillance of patients with STS. In this article, we illustrate the pertinent imaging characteristics of the commonly occurring STS and some uncommon sarcomas with unique imaging characteristics. PMID:27591491

  10. Surface modification of zirconia with polydopamine to enhance fibroblast response and decrease bacterial activity in vitro: A potential technique for soft tissue engineering applications.

    PubMed

    Liu, Mingyue; Zhou, Jianfeng; Yang, Yang; Zheng, Miao; Yang, Jianjun; Tan, Jianguo

    2015-12-01

    The quality of soft-tissue integration plays an important role in the short- and long-term success of dental implants. The aim of the present study was to provide a surface modification approach for zirconia implant abutment materials and to evaluate its influence on fibroblast behavior and oral bacteria adhesion, which are the two main factors influencing the quality of peri-implant soft-tissue seal. In this study, polydopamine (PDA)-coated zirconia was prepared and the surface characteristics were evaluated using scanning electron microscopy, atomic force microscopy, a contact-angle-measuring device, X-ray photoelectron spectroscopy, and Raman spectroscopy. The responses of human gingival fibroblasts (HGFs) to PDA-coated zirconia; i.e., adhesion, proliferation, morphology, protein synthesis, and gene expression, were analyzed. Additionally, the adhesion of Streptococcus gordonii and Streptococcus mutans to zirconia after PDA coating was assessed by scanning electron microscopy and live/dead staining. The material surface analyses suggested the successful coating of PDA onto the zirconia surface. The PDA coating significantly increased cell adhesion and proliferation compared with pristine zirconia. HGFs exhibited a high degree of spreading and secreted a high level of collagen type I on PDA-modified disks. Upregulation of integrin α5, β1, β3 and fibronectin was noted in HGFs cultured on PDA-coated zirconia. The number of adherent bacteria decreased significantly on zirconia after PDA coating. In summary, our result suggest that PDA is able to modify the surface of zirconia, influence HGFs' behavior and reduce bacterial adhesion. Therefore, this surface modification approach holds great potential for improving soft-tissue integration around zirconia abutments in clinical application. PMID:26363269

  11. Pulsed Laser Ablation of Soft Biological Tissues

    NASA Astrophysics Data System (ADS)

    Vogel, Alfred; Venugopalan, Vasan

    In this chapter we focus on the key elements that form our current understanding of the mechanisms of pulsed laser ablation of soft biological tissues. We present a conceptual framework providing mechanistic links between various ablation applications and the underlying thermodynamic and phase change processes [1]. We define pulsed laser ablation as the use of laser pulses with duration of ~1 ms or less for the incision or removal of tissue regardless of the photophysical or photochemical processes involved. However, we will confine this presentation to pulsed ablation performed on a tissue level that does not involve laser-induced plasma formation. Ablation processes within transparent tissues or cells resulting from non-linear absorption have been considered in reviews by Vogel and Venugopalan [1] and by Vogel and co-workers [2].

  12. The Genetics of Soft Connective Tissue Disorders.

    PubMed

    Vanakker, Olivier; Callewaert, Bert; Malfait, Fransiska; Coucke, Paul

    2015-01-01

    Over the last few years, the field of hereditary connective tissue disorders has changed tremendously. This review highlights exciting insights into three prototypic disorders affecting the soft connective tissue: Ehlers-Danlos syndrome, pseudoxanthoma elasticum, and cutis laxa. For each of these disorders, the identification and characterization of several novel but related conditions or subtypes have widened the phenotypic spectrum. In parallel, the vast underlying molecular network connecting these phenotypes is progressively being uncovered. Identification and characterization (both clinical and molecular) of new phenotypes within the connective tissue disorder spectrum are often key to further unraveling the pathways involved in connective tissue biology and delineating the clinical spectrum and pathophysiology of the disorders. Although difficult challenges remain, recent findings have expanded our pathophysiological understanding and may lead to targeted therapies in the near future. PMID:26002060

  13. Soft tissue cutting with ultrasonic mechanical waveguides

    NASA Astrophysics Data System (ADS)

    Wylie, Mark. P.; McGuinness, Garrett; Gavin, Graham P.

    2012-05-01

    The use of ultrasonic vibrations transmitted via small diameter wire waveguides represents a technology that has potential for minimally invasive procedures in surgery. This form of energy delivery results in distal tip mechanical vibrations with amplitudes of vibration of up to 50 μm and at frequencies between 20-50 kHz commonly reported. This energy can then be used by micro-cutting surgical tools and end effectors for a range of applications such as bone cutting, cement removal in joint revision surgery and soft tissue cutting. One particular application which has gained regulatory approval in recent years is in the area of cardiovascular surgery in the removal of calcified atherosclerotic plaques and chronic total occlusions. This paper builds on previous work that was focused on the ultrasonic perforation of soft vascular tissue using ultrasonically activated mechanical waveguides and the applied force required to initiate failure in soft tissue when compared with non-ultrasonic waveguides. An ultrasonic device and experimental rig was developed that can deliver ultrasonic vibrations to the distal tip of 1.0 mm diameter nickel-titanium waveguides. The operation of the ultrasonic device has been characterized at 22.5 kHz with achievable amplitudes of vibration in the range of 16 - 40μm. The experimental rig allows the ultrasonically activated waveguide to be advanced through a tissue sample over a range of feedrates and the waveguide-tissue interaction force can be measured during perforation into the tissue. Preliminary studies into the effects of feedrate on porcine aortic arterial tissue perforation forces are presented as part of this work. A range of amplitudes of vibration at the wire waveguide distal tip were examined. The resulting temperature increase when perforating artery wall when using the energized wire waveguides is also examined. Results show a clear multistage failure of the tissue. The first stage involves a rise in force up to some

  14. Collecting and Storing Tissue, Blood, and Bone Marrow Samples From Patients With Rhabdomyosarcoma or Other Soft Tissue Sarcoma

    ClinicalTrials.gov

    2016-03-18

    Adult Rhabdomyosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Chordoma; Desmoid Tumor; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Previously Treated Childhood Rhabdomyosarcoma; Previously Untreated Childhood Rhabdomyosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  15. The influence of soft tissue biotype on the marginal bone changes around dental implants: A 1-year prospective clinico-radiological study

    PubMed Central

    Bhat, Pragathi Raghavendra; Thakur, Srinath Lakshman; Kulkarni, Sudhindra Sushilendra

    2015-01-01

    Background: The peri-implant mucosa undergoes surgical and bacterial assaults in various stages of implant therapy, however, the literature on changes occurring in the peri-implant mucosa is minimal. This study was thus conducted to evaluate the change in the peri-implant mucosal thickness and its effect on the marginal bone levels around dental implants treated in a conventional two-stage implant therapy. Materials and Methods: A total of 36 implants were placed in 22 subjects. Two subjects dropped out. Thirty-three implants in 20 subjects were then evaluated. Initial mucosal thickness, marginal bone levels on radiographs, pain, and exudation were evaluated. All these parameters were recorded at the time of implant placement, at the time of cementation of final restoration, 6 months and 12 months post cementation/restoration. Results: The peri-implant mucosal thickness reduced from implant placement to second stage and till restorations and was statistically significant, in both the thick and thin biotypes, however, at 12 months there was a rebound of the tissue thickness, which was more in the thick biotype (P < 0.05). At 1-year follow-up, there was a reduction in the marginal bone levels, which was more in the thick biotype as compared to the thin biotype (P < 0.05). Conclusion: The mucosa at implant sites undergoes a reduction in thickness from the time of implant placement till the placement of final restorations. The placement of the final restorations and then end of active therapy leads to a rebound of the tissue thickness. Sites with thicker tissues preoperatively have a lesser bone loss and better rebound as compared to thinner tissues. PMID:26941514

  16. The fracture toughness of soft tissues.

    PubMed

    Taylor, David; O'Mara, Niamh; Ryan, Eoin; Takaza, Michael; Simms, Ciaran

    2012-02-01

    Fracture toughness is important for any material, but to date there have been few investigations of this mechanical property in soft mammalian tissues. This paper presents new data on porcine muscle tissue and a detailed analysis of all previous work. The conclusion is that, in most cases, fracture toughness has not in fact been measured for these tissues. Reanalysis of the previous work shows that failure of the test specimens generally occurred at the material's ultimate strength, implying that no information about toughness can be obtained from the results. This finding applied to work on cartilage, artificial neocartilage, muscle and the TMJ disc. Our own data, which was also found to be invalid, gave measured fracture toughness values which were highly variable and showed a strong dependence on the crack growth increment. The net-section failure stress and failure energy were relatively constant in large specimens, independent of crack length, whilst for smaller specimens they showed a strong size effect. These findings are explained by the fact that the process zone size, estimated here using the critical distance parameter L, was similar to, or larger than, critical specimen dimensions (crack length and specimen width). Whilst this analysis casts doubt on much of the published literature, a useful finding is that soft tissues are highly tolerant of defects, able to withstand the presence of cracks several millimetres in length without significant loss of strength. PMID:22301183

  17. Attempts to obtain re-osseointegration following experimental peri-implantitis in dogs.

    PubMed

    Wetzel, A C; Vlassis, J; Caffesse, R G; Hämmerle, C H; Lang, N P

    1999-04-01

    The purpose of this study was to examine the healing potential and re-osseointegration in peri-implant infection defects adjacent to various implant surfaces. In 7 female Beagle dogs, a total of 41 titanium oral implants (ITI, Straumann, Waldenburg; Switzerland) with a sink depth of 6 mm (diameter 2.8 mm) were placed transmucosally. Four different surface configurations (TPS: titanium plasma sprayed (10); SLA: sand blasted and acid-etched (13); M: machined and smooth (11); TPS furc.: titanium plasma sprayed with coronally placed perforation to mimic a furcation (7) were distributed among the animals and locations. Following a healing period of 3 months, silk ligatures were placed and oral cleaning procedures abolished for 4 months to induce a vertical bone loss of about 40%. Following mechanical and chemical cleansing (chlorhexidine and metronidazole) and disinfection, the lesions were either sham operated (11) or subjected to a GTR procedure using ePTFE (30). After 6 months of healing the animals were killed and the jaws histologically evaluated. Six membranes were lost TPS: (1); SLA: (2); M: (2); TPS furc: (1) and 3 membranes exposed TPS: (1); M: (2) and excluded from further evaluation. Owing to the loss of 1 implant and infection of the membranes in the TPS furc group, this implant configuration was discarded from further analysis. For TPS surfaces, bone fill was 2.6 mm (73% of the distance from the bottom of the defect to the shoulder of the implant) sites with (4 GTR) and 0.33 mm (14%) for sites without membrane (2 controls). Re-osseointegration was 0.5 mm (14%) in the test group and 0.3 mm (14%) in the control. For SLA surfaces bone fill was 2.3 mm (83%) for sites with (7 GTR) and 0.41 mm (15%) for sites without membranes (4 controls). Re-osseointegration was 0.6 mm (20%) and 0.3 mm (11%) respectively. Corresponding values for M surfaces were 2.2 mm (62%) with 4 GTR) and 0.82 mm (31%) without membranes. Re-osseointegration was 0.07 mm (2%) and 0.19 mm (7

  18. Studying Genes in Tissue Samples From Younger and Adolescent Patients With Soft Tissue Sarcomas

    ClinicalTrials.gov

    2016-05-13

    Childhood Alveolar Soft-part Sarcoma; Childhood Angiosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Childhood Epithelioid Sarcoma; Childhood Fibrosarcoma; Childhood Leiomyosarcoma; Childhood Liposarcoma; Childhood Malignant Mesenchymoma; Childhood Neurofibrosarcoma; Childhood Synovial Sarcoma; Chordoma; Desmoid Tumor; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Recurrent Childhood Soft Tissue Sarcoma

  19. Adjunctive Systemic and Local Antimicrobial Therapy in the Surgical Treatment of Peri-implantitis: A Randomized Controlled Clinical Trial.

    PubMed

    Carcuac, O; Derks, J; Charalampakis, G; Abrahamsson, I; Wennström, J; Berglundh, T

    2016-01-01

    The aim of the present randomized controlled clinical trial was to investigate the adjunctive effect of systemic antibiotics and the local use of chlorhexidine for implant surface decontamination in the surgical treatment of peri-implantitis. One hundred patients with severe peri-implantitis were recruited. Surgical therapy was performed with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated at 1 y. A binary logistic regression analysis was used to identify factors influencing the probability of treatment success, that is, probing pocket depth ≤5 mm, absence of bleeding/suppuration on probing, and no additional bone loss. Treatment success was obtained in 45% of all implants but was higher in implants with a nonmodified surface (79%) than those with a modified surface (34%). The local use of chlorhexidine had no overall effect on treatment outcomes. While adjunctive systemic antibiotics had no impact on treatment success at implants with a nonmodified surface, a positive effect on treatment success was observed at implants with a modified surface. The likelihood for treatment success using adjunctive systemic antibiotics in patients with implants with a modified surface, however, was low. As the effect of adjunctive systemic antibiotics depended on implant surface characteristics, recommendations for their use in the surgical treatment of peri-implantitis should be based on careful assessments of the targeted implant (ClinicalTrials.gov NCT01857804). PMID:26285807

  20. Temperature elevations in endosseous dental implants and the peri-implant bone during diode-laser-assisted surface decontamination

    NASA Astrophysics Data System (ADS)

    Kreisler, Matthias; Schoof, Juergen; Langnau, Ernst; Al Haj, Haitham; d'Hoedt, Bernd

    2002-06-01

    The aim of the study was to investigate temperature elevations in the implant surface and the peri-implant bone during simulated surface decontamination of endosseous dental implants with an 809 nm semiconductor laser. Stepped cylinder implants were inserted into bone blocks cut from resected pig femurs. An artificial peri-implant bone defect provided access for the irradiation of the implant surface. A 600 micron optic fiber was used at a distance of 0.5 mm from the implant surface. Power output varied between 0.5 and 2.5 W in the cw-mode. Power density was between 176.9 and 884.6 Wcm-2. The bone block was placed into a 37 degree(s)C water bath in order to simulate in vivo thermal conductivity and diffusitivity of heat. Temperature elevations during irradiation were registered by means of K-Type thermocouples and a short wave thermocamera. In a time and energy-dependant manner, the critical threshold of 47 degree(s)C was exceeded in the peri-implant bone. Surface peak temperatures in the focus of up to 427.8 degree(s)C were observed. Implant surface decontamination with an 809 nm GaAlAs laser must be limited to a maximum of 10 s at an energy density below 350 wcm-2 to ensure a safe clinical treatment.

  1. Nasal soft tissue trauma and management.

    PubMed

    Immerman, Sara; Constantinides, Minas; Pribitkin, Edmund A; White, W Matthew

    2010-12-01

    The nose is the most prominent of all facial structures and is susceptible to many types of trauma. All soft tissue injuries of the nose have the potential to distort its appearance and adversely affect the patient's self-image and self-esteem. Once life-threatening injuries are stabilized, a careful history and physical exam should be completed and treatment individualized. The ultimate objective of treatment is to achieve both functional and cosmetic restoration with timely diagnosis and repair. Immediate nasal reconstruction is ideal when medically possible because this decreases long-term sequelae. PMID:21086240

  2. Pulsed Nd:YAG laser treatment for failing dental implants due to peri-implantitis

    NASA Astrophysics Data System (ADS)

    Nicholson, Dawn; Blodgett, Kris; Braga, Charles; Finkbeiner, Larry; Fourrier, Jeanne; George, John; Gregg, Robert; Honigman, Allen; Houser, Bruce; Lamas, William; Lehrman, Neal; Linden, Eric; McCarthy, Delwin; McCawley, Tom; McCormick, Randy; Marcus, Ed; Noraian, Kirk; Rubelman, Peter; Salama, Maurice; Saunders, Steven; Seamons, Brandon; Thein, David; Toms, Michael; Vassos, George; Harris, David M.

    2014-02-01

    A large percentage of dental implants experience complications, most commonly, infection leading to peri-implantitis and peri-mucositis, inflammatory disease involving pathogen contamination. It presents with radiographic findings of crestal bone loss. At this time there appears to be no compelling evidence for an effective intervention. The LANAP protocol is a FDA cleared surgical protocol that produces new attachment and bone regeneration when applied to periodontally infected natural teeth. The LANAP protocol and laser dosimetry have been modified to treat ailing and failing implants. Twenty-one clinicians who have been trained to perform the LANAP protocol and the LAPIPTM protocol have volunteered 26 LAPIP case reports. The time from implant to intervention ranges from 3 months to 16 years. Post-LAPIP radiographs range from 2-48 months. Ten cases were excluded for technical reasons. All 16 remaining cases provide radiographic evidence of increase in crestal bone mass around the implant and, when reported, probe depth reductions. All treating clinicians report control of the infection, reversal of bone loss and rescue of the incumbent implant. Although the success/failure rate cannot be judged from these data, any successes in this area deserve reporting and further study.

  3. Mga is essential for the survival of pluripotent cells during peri-implantation development.

    PubMed

    Washkowitz, Andrew J; Schall, Caroline; Zhang, Kun; Wurst, Wolfgang; Floss, Thomas; Mager, Jesse; Papaioannou, Virginia E

    2015-01-01

    The maintenance and control of pluripotency is of great interest in stem cell biology. The dual specificity T-box/basic-helix-loop-helix-zipper transcription factor Mga is expressed in the pluripotent cells of the inner cell mass (ICM) and epiblast of the peri-implantation mouse embryo, but its function has not been investigated previously. Here, we use a loss-of-function allele and RNA knockdown to demonstrate that Mga depletion leads to the death of proliferating pluripotent ICM cells in vivo and in vitro, and the death of embryonic stem cells (ESCs) in vitro. Additionally, quiescent pluripotent cells lacking Mga are lost during embryonic diapause. Expression of Odc1, the rate-limiting enzyme in the conversion of ornithine into putrescine in the synthesis of polyamines, is reduced in Mga mutant cells, and the survival of mutant ICM cells as well as ESCs is rescued in culture by the addition of exogenous putrescine. These results suggest a mechanism whereby Mga influences pluripotent cell survival through regulation of the polyamine pool in pluripotent cells of the embryo, whether they are in a proliferative or quiescent state. PMID:25516968

  4. Mga is essential for the survival of pluripotent cells during peri-implantation development

    PubMed Central

    Washkowitz, Andrew J.; Schall, Caroline; Zhang, Kun; Wurst, Wolfgang; Floss, Thomas; Mager, Jesse; Papaioannou, Virginia E.

    2015-01-01

    The maintenance and control of pluripotency is of great interest in stem cell biology. The dual specificity T-box/basic-helix-loop-helix-zipper transcription factor Mga is expressed in the pluripotent cells of the inner cell mass (ICM) and epiblast of the peri-implantation mouse embryo, but its function has not been investigated previously. Here, we use a loss-of-function allele and RNA knockdown to demonstrate that Mga depletion leads to the death of proliferating pluripotent ICM cells in vivo and in vitro, and the death of embryonic stem cells (ESCs) in vitro. Additionally, quiescent pluripotent cells lacking Mga are lost during embryonic diapause. Expression of Odc1, the rate-limiting enzyme in the conversion of ornithine into putrescine in the synthesis of polyamines, is reduced in Mga mutant cells, and the survival of mutant ICM cells as well as ESCs is rescued in culture by the addition of exogenous putrescine. These results suggest a mechanism whereby Mga influences pluripotent cell survival through regulation of the polyamine pool in pluripotent cells of the embryo, whether they are in a proliferative or quiescent state. PMID:25516968

  5. Amino acids and conceptus development during the peri-implantation period of pregnancy.

    PubMed

    Bazer, Fuller W; Johnson, Gregory A; Wu, G

    2015-01-01

    The dialogue between the mammalian conceptus (embryo/fetus and associated membranes) involves signaling for pregnancy recognition and maintenance of pregnancy during the critical peri-implantation period of pregnancy when the stage is set for implantation and placentation that precedes fetal development. Uterine epithelial cells secrete and/or transport a wide range of molecules, including nutrients, collectively referred to as histotroph that are transported into the fetal-placental vascular system to support growth and development of the conceptus. The availability of uterine-derived histotroph has long-term consequences for the health and well-being of the fetus and the prevention of Developmental Origins of Health and Disease (DOHAD). Although mechanisms responsible for differential growth and development of the conceptus resulting in DOHAD phenomena remain unclear, epigenetic events involving methylation of DNA are likely mechanisms. Histotroph includes serine and methionine which can contribute to the one carbon pool, and arginine, lysine and histidine residues which may be targets of methylation. It is also clear that supplementing the diet with arginine enhances fetal-placental development in rodents, swine and humans through mechanisms that remain to be elucidated. However, molecules secreted by conceptuses such as interferon tau in ruminants, estrogens and interferons in pigs and chorionic gonadotrophin, along with progesterone, regulate expression of genes for nutrient transporters. Understanding mechanisms whereby select nutrients regulate expression of genes in cell signaling pathways critical to conceptus development, implantation and placentation is required for improving successful establishment and maintenance of pregnancy in mammals. PMID:25956294

  6. Platform-Switching to Preserve Peri-Implant Bone: A Meta-Analysis.

    PubMed

    Aslam, Ayesha; Ahmed, Bilal

    2016-04-01

    The objective of this meta-analysis was to determine the literature-based evidence if platform-switching has an effect in preventing marginal bone loss around prosthodontic implants following their functional loading in comparison to conventional platform-matching. A systematic literature search was performed on PubMed, Science Direct, Google Scholar for Literature from 1950 to January 2015, human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting marginal bone loss around platform-switched and matched implants. Six RCTs with a low risk of bias revealed a significantly less mean marginal bone loss (0.57 mm [CI 95% 0.30; 0.84]) around platform-switched implants in comparison to platform-matched implants [1.14 mm (CI 95% 0.69; 1.6, p < 0.001)]. The meta-analysis revealed a significantly less peri-implant marginal bone loss with platform-switched implants as compared to platform-matched implants. The qualitative analysis depicts a trend favouring the platform-switching technique over platform- matching technique to prevent marginal bone loss. However, owing to the heterogeneity of the included studies, their results necessitate cautious interpretation. PMID:27097705

  7. Bone and Soft Tissue Pathology: Diagnostic and Prognostic Implications.

    PubMed

    Gibbs, Julie; Henderson-Jackson, Evita; Bui, Marilyn M

    2016-10-01

    Soft tissue and bone tumors are a heterogeneous group of tumors most often classified according to the type of tissue they most closely histologically resemble. Although sarcomas are rare, greater than 100 histologic subtypes of benign and malignant soft tissue and bone tumors are currently recognized. In this article, the authors review the current pathologic definitions, the classification and grading systems, supportive ancillary techniques, and the prognostic implications for some of the more common soft tissue and bone tumors. PMID:27542635

  8. Nonlinear noise waves in soft biological tissues

    NASA Astrophysics Data System (ADS)

    Rudenko, O. V.; Gurbatov, S. N.; Demin, I. Yu.

    2013-09-01

    The study of intense waves in soft biological tissues is necessary both for diagnostics and therapeutic aims. Tissue represents an inherited medium with frequency-dependent dissipative properties, in which waves are described by nonlinear integro-differential equations. The equations for such waves are well known. Their group analysis has been performed, and a number of exact solutions have been found. However, statistical problems for nonlinear waves in tissues have hardly been studied. As well, for medical applications, both intense noise waves and waves with fluctuating parameters can be used. In addition, statistical solutions are simpler in structure than regular solutions; they are useful for understanding the physics of processes. Below a general approach is described for solving nonlinear statistical problems applied to the considered mathematical models of biological tissues. We have calculated the dependences of the intensities of the narrowband noise harmonics on distance. For wideband noise, we have calculated the dependence of the spectral integral intensity on distance. In all cases, wave attenuation is determined both by the specific dissipative properties of the tissue and the nonlinearity of the medium.

  9. Longitudinal nonlinear wave propagation through soft tissue.

    PubMed

    Valdez, M; Balachandran, B

    2013-04-01

    In this paper, wave propagation through soft tissue is investigated. A primary aim of this investigation is to gain a fundamental understanding of the influence of soft tissue nonlinear material properties on the propagation characteristics of stress waves generated by transient loadings. Here, for computational modeling purposes, the soft tissue is modeled as a nonlinear visco-hyperelastic material, the geometry is assumed to be one-dimensional rod geometry, and uniaxial propagation of longitudinal waves is considered. By using the linearized model, a basic understanding of the characteristics of wave propagation is developed through the dispersion relation and in terms of the propagation speed and attenuation. In addition, it is illustrated as to how the linear system can be used to predict brain tissue material parameters through the use of available experimental ultrasonic attenuation curves. Furthermore, frequency thresholds for wave propagation along internal structures, such as axons in the white matter of the brain, are obtained through the linear analysis. With the nonlinear material model, the authors analyze cases in which one of the ends of the rods is fixed and the other end is subjected to a loading. Two variants of the nonlinear model are analyzed and the associated predictions are compared with the predictions of the corresponding linear model. The numerical results illustrate that one of the imprints of the nonlinearity on the wave propagation phenomenon is the steepening of the wave front, leading to jump-like variations in the stress wave profiles. This phenomenon is a consequence of the dependence of the local wave speed on the local deformation of the material. As per the predictions of the nonlinear material model, compressive waves in the structure travel faster than tensile waves. Furthermore, it is found that wave pulses with large amplitudes and small elapsed times are attenuated over shorter spans. This feature is due to the elevated

  10. Soft Tissue Injections in the Athlete

    PubMed Central

    Nepple, Jeffrey J.; Matava, Matthew J.

    2009-01-01

    Background: Injections into or adjacent to soft tissue structures, including muscle, tendon, bursa, and fascia, for pain relief and an earlier return to play have become common in the field of sports medicine. Study Design: Clinical review. Results: Corticosteroids, local anesthetics, and ketorolac tromethamine (Toradol) are the most commonly used injectable agents in athletes. The use of these injectable agents have proven efficacy in some disorders, whereas the clinical benefit for others remain questionable. All soft tissue injections performed for pain control and/or an anti-inflammatory effect have potentially serious side effects, which must be considered, especially in the pregame setting. Conclusions: The primary concern regarding corticosteroid and local anesthetic injections is an increased risk of tendon rupture associated with the direct injection into the tendon. Intramuscular Toradol injections provide significant analgesia, as well as an anti-inflammatory effect via its inhibitory effect on the cyclooxygenase pathway. The risk of bleeding associated with Toradol use is recognized but not accurately quantified. PMID:23015899

  11. Vascular Compromise from Soft Tissue Augmentation

    PubMed Central

    Humphrey, Shannon; Carruthers, Jean D.A.; Carruthers, Alastair

    2014-01-01

    The popularity of soft tissue fillers is, in part, due to their favorable side-effect profile. However, serious complications can occur. The authors describe their extensive clinical experience with soft-tissue augmentation and the rare complication of vascular compromise, which can lead to necrosis and scarring. Over a 10-year period between January 2003 and January 2013, the authors observed a total of 12 cases of vascular compromise. Eight patients in their clinical practice showed evidence of vascular compromise out of a total of 14,355 filler injections (0.05%). In addition, four patients treated with an experimental particulate filler had vascular complications. All cases were examined for filler type, location of complication, risk factors, treatment, and outcomes. Although treatment plans differed for each patient in their series, all cases of vascular compromise resolved fully. The authors believe that an office-based protocol for both immediate and ongoing care—including a thorough individualized assessment and treatment plan for each patient—is critical to timely and effective resolution of side effects. They propose key recommendations for the prevention and management of vascular compromise to improve patient outcomes and reduce the risk of permanent complications. PMID:25276276

  12. Pericyte Antigens in Perivascular Soft Tissue Tumors

    PubMed Central

    Shen, Jia; Shrestha, Swati; Yen, Yu-Hsin; Asatrian, Greg; Mravic, Marco; Soo, Chia; Ting, Kang; Dry, Sarah M.; Peault, Bruno; James, Aaron W.

    2015-01-01

    Introduction Perivascular soft tissue tumors are relatively uncommon neoplasms of unclear line of differentiation, although most are presumed to originate from pericytes or modified perivascular cells. Among these, glomus tumor, myopericytoma, and angioleiomyoma share a spectrum of histologic findings and a perivascular growth pattern. In contrast, solitary fibrous tumor (previously termed hemangiopericytoma) was once hypothesized to have pericytic differentiation. Methods Here, we systematically examine pericyte immunohistochemical markers among glomus tumor (including malignant glomus tumor), myopericytoma, angioleiomyoma, and solitary fibrous tumor. Immunohistochemical staining and semiquantification was performed using well-defined pericyte antigens, including αSMA, CD146, and PDGFRβ. Results Glomus tumor and myopericytoma demonstrate diffuse staining for all pericyte markers, including immunohistochemical reactivity for αSMA, CD146, and PDGFRβ. Malignant glomus tumors all showed some degree of pericyte marker immunoreactivity, although it was significantly reduced. Angioleiomyoma shared a similar αSMA + CD146 + PDGFRβ+ immunophenotype; however, this was predominantly seen in the areas of perivascular tumor growth. Solitary fibrous tumors showed patchy PDGFRβ immunoreactivity only. Discussion In summary, pericyte marker expression is a ubiquitous finding in glomus tumor, myopericytoma, and angioleiomyoma. Malignant glomus tumor shows a comparative reduction in pericyte marker expression, which may represent partial loss of pericytic differentiation. Pericyte markers are essentially not seen in solitary fibrous tumor. The combination of αSMA, CD146, and PDGFRβ immunohistochemical stainings may be of utility for the evaluation of pericytic differentiation in soft tissue tumors. PMID:26085647

  13. Metachronous Bilateral Extremity Soft Tissue Sarcomas

    PubMed Central

    Nowrasteh, Ghodratollah; Aziz, Tanim; Assas, Mohammed Al; Nuaimi, Lateefa Al; Marzouqi, Saeeda; Quadri, Asif A.M.; Alrawi, Sadir

    2016-01-01

    Case series Patient: Male, 44 • Male, 58 Final Diagnosis: Soft tissue sarcomas Symptoms: Discomfort • swelling Medication: — Clinical Procedure: Image guided biopsy • metastatic work up • neoadjuvant radiotherapy • radical resection Specialty: Surgery Objective: Rare disease Background: Soft tissue sarcomas (STS) account for approximately 1% of adult malignancies, with 50 to 60% occurring in the extremities. Liposarcoma is the most common type of STS and represent about 20% of total adult sarcomas. There are rare syndromes associated with increased risk of developing STS. Further, chemical compounds such as chlorinated phenols and a few chemotherapeutic drugs have been linked to STS, along with ionizing radiation. Nevertheless, the etiology is uncertain for most of these lesions. Case Report: This report details 2 cases of metachronous bilateral STS of the lower extremities. The first of these presented as a local recurrence of a previously resected right thigh liposarcoma and a new liposarcoma in the left thigh. As mentioned above, among the different subtypes of STS, liposarcoma has the highest tendency for multifocality. The second patient had multifocal metachronous leiomyosarcoma with lung metastases occurring simultaneously with the second presentation. Leiomyosarcoma is another subtype reported to present with multi-focal disease. Conclusions: Despite the rarity of bilateral lesions, their occurrence should not be overlooked in the initial diagnosis and follow-up of the initially detected tumor. Early detection can affect patient survival because their presence predicts unfavorable outcomes. PMID:26744032

  14. Multidisciplinary Management of Soft Tissue Sarcoma

    PubMed Central

    Nystrom, Lukas M.; Reimer, Nickolas B.; Reith, John D.; Dang, Long; Zlotecki, Robert A.; Scarborough, Mark T.; Gibbs, C. Parker

    2013-01-01

    Soft tissue sarcoma is a rare malignancy, with approximately 11,000 cases per year encountered in the United States. It is primarily encountered in adults but can affect patients of any age. There are many histologic subtypes and the malignancy can be low or high grade. Appropriate staging work up includes a physical exam, advanced imaging, and a carefully planned biopsy. This information is then used to guide the discussion of definitive treatment of the tumor which typically involves surgical resection with a negative margin in addition to neoadjuvant or adjuvant external beam radiation. Advances in imaging and radiation therapy have made limb salvage surgery the standard of care, with local control rates greater than 90% in most modern series. Currently, the role of chemotherapy is not well defined and this treatment is typically reserved for patients with metastatic or recurrent disease and for certain histologic subtypes. The goal of this paper is to review the current state of the art in multidisciplinary management of soft tissue sarcoma. PMID:23983648

  15. Baicalin can attenuate the inhibitory effects of mifepristone on Wnt pathway during peri-implantation period in mice.

    PubMed

    Chen, J G; Chen, T; Ding, Y; Han, L; Zhou, F Y; Chen, W Z; Ding, M X

    2015-05-01

    Wnts are considered as important factors in uterus developmental process and embryo implantation. Baicalin has been demonstrated to possess tocolytic properties. In order to investigate the effect of baicalin on the Wnt signaling pathway during the peri-implantation, pregnant Kuming mice were randomly divided into four groups: control group, baicalin group administered with 40mg/kg BW of baicalin through an intragastric gavage on day 2 to 7 of the pregnancy (Pd2-Pd7), mifepristone group treated with 4mg/kg BW of mifepristone, an abortifacient agent, via subcutaneous administration on Pd4, and baicalin+mifepristone group treated with their combination. The concentrations of the implantation-related steroid hormones (progesterone and estradiol) in the blood serum were measured with RIA. The gene and protein expression levels of the important molecules of the Wnt pathway (Wnt4, LRP6, Dkk1 and β-catenin) in the endometrium were detected with RT-PCR and western blot, respectively. The results showed that baicalin decreased (P<0.05) the estradiol levels on Pd4-Pd8 and increased (P<0.05) the progesterone levels on Pd3-Pd8. Mifepristone increased (P<0.05) the estradiol levels on Pd5-Pd8 and decreased (P<0.05) the progesterone levels on Pd6-Pd8. Compared with the control group, baicalin increased the gene and protein expression levels of Wnt4, LRP6 and β-catenin (P<0.05) and decreased the gene and protein expression levels of Dkk1 (P<0.05) during the middle-to-late stage of the experiment in mice uterine tissue. Baicalin alleviated the mifepristone-induced increase or decrease in the serum levels of progesterone and estradiol, and the gene or protein expression levels of Wnt4, LRP6 and β-catenin. The tocolytic properties tocolysis of baicalin may be realized through regulating the levels of estrogen/progesterone and the important components of canonical Wnt signaling pathway during the embryo implantation process intervened with the subcutaneous administration of

  16. Current management of pediatric soft tissue sarcomas.

    PubMed

    Sangkhathat, Surasak

    2015-11-01

    Pediatric soft tissue sarcomas are a group of malignant neoplasms arising within embryonic mesenchymal tissues during the process of differentiation into muscle, fascia and fat. The tumors have a biphasic peak for age of incidence. Rhabdomyosarcoma (RMS) is diagnosed more frequently in younger children, whereas adult-type non-RMS soft tissue sarcoma is predominately observed in adolescents. The latter group comprises a variety of rare tumors for which diagnosis can be difficult and typically requires special studies, including immunohistochemistry and molecular genetic analysis. Current management for the majority of pediatric sarcomas is based on the data from large multi-institutional trials, which has led to great improvements in outcomes over recent decades. Although surgery remains the mainstay of treatment, the curative aim cannot be achieved without adjuvant treatment. Pre-treatment staging and risk classification are of prime importance in selecting an effective treatment protocol. Tumor resectability, the response to induction chemotherapy, and radiation generally determine the risk-group, and these factors are functions of tumor site, size and biology. Surgery provides the best choice of local control of small resectable tumors in a favorable site. Radiation therapy is added when surgery leaves residual disease or there is evidence of regional spread. Chemotherapy aims to reduce the risk of relapse and improve overall survival. In addition, upfront chemotherapy reduces the aggressiveness of the required surgery and helps preserve organ function in a number of cases. Long-term survival in low-risk sarcomas is feasible, and the intensity of treatment can be reduced. In high-risk sarcoma, current research is allowing more effective disease control. PMID:26566481

  17. Current management of pediatric soft tissue sarcomas

    PubMed Central

    Sangkhathat, Surasak

    2015-01-01

    Pediatric soft tissue sarcomas are a group of malignant neoplasms arising within embryonic mesenchymal tissues during the process of differentiation into muscle, fascia and fat. The tumors have a biphasic peak for age of incidence. Rhabdomyosarcoma (RMS) is diagnosed more frequently in younger children, whereas adult-type non-RMS soft tissue sarcoma is predominately observed in adolescents. The latter group comprises a variety of rare tumors for which diagnosis can be difficult and typically requires special studies, including immunohistochemistry and molecular genetic analysis. Current management for the majority of pediatric sarcomas is based on the data from large multi-institutional trials, which has led to great improvements in outcomes over recent decades. Although surgery remains the mainstay of treatment, the curative aim cannot be achieved without adjuvant treatment. Pre-treatment staging and risk classification are of prime importance in selecting an effective treatment protocol. Tumor resectability, the response to induction chemotherapy, and radiation generally determine the risk-group, and these factors are functions of tumor site, size and biology. Surgery provides the best choice of local control of small resectable tumors in a favorable site. Radiation therapy is added when surgery leaves residual disease or there is evidence of regional spread. Chemotherapy aims to reduce the risk of relapse and improve overall survival. In addition, upfront chemotherapy reduces the aggressiveness of the required surgery and helps preserve organ function in a number of cases. Long-term survival in low-risk sarcomas is feasible, and the intensity of treatment can be reduced. In high-risk sarcoma, current research is allowing more effective disease control. PMID:26566481

  18. Soft tissue modelling through autowaves for surgery simulation.

    PubMed

    Zhong, Yongmin; Shirinzadeh, Bijan; Alici, Gursel; Smith, Julian

    2006-09-01

    Modelling of soft tissue deformation is of great importance to virtual reality based surgery simulation. This paper presents a new methodology for simulation of soft tissue deformation by drawing an analogy between autowaves and soft tissue deformation. The potential energy stored in a soft tissue as a result of a deformation caused by an external force is propagated among mass points of the soft tissue by non-linear autowaves. The novelty of the methodology is that (i) autowave techniques are established to describe the potential energy distribution of a deformation for extrapolating internal forces, and (ii) non-linear materials are modelled with non-linear autowaves other than geometric non-linearity. Integration with a haptic device has been achieved to simulate soft tissue deformation with force feedback. The proposed methodology not only deals with large-range deformations, but also accommodates isotropic, anisotropic and inhomogeneous materials by simply changing diffusion coefficients. PMID:16960747

  19. Use of buccal fat pad to repair post-extraction peri-implant bone defects in the posterior maxilla. A preliminary prospective study

    PubMed Central

    Peñarrocha-Diago, María; Alonso-González, Rocío; Aloy-Prósper, Amparo; Peñarrocha-Oltra, David; Camacho, Fabio; Peñarrocha-Diago, Miguel

    2015-01-01

    Background Extensive literature exists about the use of the BFP in the treatment of oral defects but, to our knowledge, no article refers to the use of the BFP as a substitute of the membrane barriers for treatment of peri-implant bone defects. The aim was to evaluate the use of the buccal fat pad as a coating material for bone grafting in the peri-implant bone defect regeneration of immediate implants placed in the posterior maxilla. Material and Methods A preliminary prospective study of patients involving immediate implants in which the buccal fat pad was used as a coating material to peri-implant bone defects was carried out. The outcome measures assessed were: postoperative pain and swelling, complications related to buccal fat pad surgery, implant survival and success rates and peri-implant marginal bone loss at 12 months of prosthetic loading. Results Twenty-seven patients (17 women and 10 men) with a mean age of 55.3 ± 8.9 years, and a total of 43 implants were included. Two-thirds of the patients reported either no pain or only mild intensity pain and moderate inflammation, two days after surgery. Post-operative period was well tolerated by the patients and no serious complications occurred. None wound dehiscence occurred. Implant survival and success rates were 97.6% and the average marginal bone loss 1 year after loading was 0.58 ± 0.27 mm. Conclusions Within the limits of this preliminary study, the use of the buccal fat pad as a coating material for bone grafting in peri-implant bone defects placed in the upper posterior maxilla was a well-tolerated technique by patients; high implant success rate was achieved with a minimal peri-implant marginal bone loss at 12 months of prosthetic loading. Key words:Buccal fat pad, immediate implant, peri-implant bone defect. PMID:26241450

  20. Role of soft tissues in metacarpal fracture fixation.

    PubMed

    Ouellette, Elizabeth Anne; Dennis, Jay J; Milne, Edward L; Latta, Loren L; Makowski, Anna-Lena

    2003-07-01

    The contribution of soft tissues in stabilizing fracture fixation in metacarpals is appreciated clinically, but no quantitative biomechanical study of their role has been done. All previous studies of fracture fixation in vitro have been done on metacarpals denuded of soft tissues. To quantify the role of soft tissues in metacarpal fracture fixation, the biomechanical effectiveness of four fixation devices was examined in human cadaver metacarpals with and without soft tissues. Values were compared for three nonrigid methods (expandable intramedullary fixation devices, crossed Kirschner wires, and single half-pin frames) and one rigid method (dorsal plates) in 45 disarticulated metacarpals stripped of soft tissues (denuded) and in 46 metacarpals in whole hands with all soft tissues remaining (intact). Mechanical testing to complete failure in three-point apex dorsal bending was done in all specimens. Ultimate moment (strength) of each of the four fixation methods was significantly greater in intact specimens than in denuded specimens. Crossed Kirschner wires were most stable in intact specimens, and dorsal plates were more stable in denuded specimens. The results show that soft tissues contribute to the strength of fracture fixation. Clinically, surgeons may be able to use a less invasive fixation method than plating without compromising the strength of metacarpal fixation in patients whose soft tissues are not severely disrupted and the fracture configuration allows. Plating may offer optimum stability in patients whose soft tissues are damaged severely and provide less strengthening of the fracture construct. PMID:12838068

  1. Contemporary Management of Retroperitoneal Soft Tissue Sarcomas.

    PubMed

    Olimpiadi, Yuliya; Song, Suisui; Hu, James S; Matcuk, George R; Chopra, Shefali; Eisenberg, Burton L; Sener, Stephen F; Tseng, William W

    2015-08-01

    Management of retroperitoneal soft tissue sarcomas (RP STS) can be very challenging. In contrast to the more common extremity STS, the two predominant histologic subtypes encountered in the retroperitoneum are well-differentiated/dedifferentiated liposarcoma and leiomyosarcoma. Surgery remains the mainstay of treatment for RP STS. Preoperative planning and anticipation of the need for resection of adjacent organs/structures are critical. The extent of surgery, including the role of compartmental resection, is still controversial. Radiation therapy may be an important adjunct to surgery to provide locoregional disease control; this is currently being evaluated in the preoperative setting in the EORTC STRASS trial. Systemic therapy, tailored to the specific histologic subtype, may also be of benefit for the management of RP STS. Further investigation of novel therapies (e.g., targeted therapies, immunotherapy) is needed. Overall, multi-institutional collaboration is important moving forward, to continue to better understand and optimize management of this disease. PMID:26092408

  2. [Grading of soft tissue and bone sarcomas].

    PubMed

    Petersen, I; Wardelmann, E

    2016-07-01

    Malignancy grading is an essential element in the classification of sarcomas. It correlates with the prognosis of the disease and the risk of metastasis. This article presents the grading schemes for soft tissue, bone and pediatric sarcomas. It summarizes the histological criteria of the Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system and the Pediatric Oncology Group as well as the grading of bone tumors by the College of American Pathologists (CAP). Furthermore, the potential relevance of gene expression signatures, the complexity index in sarcoma (CINSARC) and single genetic alterations (p53, MDM2, p16, SWI/SNF, EWSR1 fusions and PAX3/PAX7-FOXO1 fusions) for the prognosis of sarcomas are discussed. PMID:27384333

  3. Completely extruded talus without soft tissue attachments.

    PubMed

    Choi, Young Rak; Jeong, Jae Jung; Lee, Ho Seong; Kim, Sang Woo; Suh, Jin-Soo

    2011-03-29

    A completely extruded talus without any remaining soft tissue attachments is extremely rare. The present report describes treatment of a 45-year-old man who sustained a completely extruded talus injury following a rock-climbing fall. Upon admission, the extruded talus was deep-frozen in our bone bank. The open ankle joint underwent massive wound debridement and irrigation for 3 days. Four days later we performed a primary subtalar fusion between the extruded talus and the calcaneus, anticipating revascularization from the calcaneus. However, aseptic loosening and osteolysis developed around the screw and talus. At 12 months post-trauma we performed a tibiocalcaneal ankle fusion with a femoral head allograft to fill the talar defect. Follow-up at 24 months post-trauma showed the patient had midfoot motion, tibio-talar-calcaneal fusion, and was able partake in 4-hour physical activity twice per week. PMID:24765266

  4. Fibroblast involvement in soft connective tissue calcification

    PubMed Central

    Ronchetti, Ivonne; Boraldi, Federica; Annovi, Giulia; Cianciulli, Paolo; Quaglino, Daniela

    2013-01-01

    Soft connective tissue calcification is not a passive process, but the consequence of metabolic changes of local mesenchymal cells that, depending on both genetic and environmental factors, alter the balance between pro- and anti-calcifying pathways. While the role of smooth muscle cells and pericytes in ectopic calcifications has been widely investigated, the involvement of fibroblasts is still elusive. Fibroblasts isolated from the dermis of pseudoxanthoma elasticum (PXE) patients and of patients exhibiting PXE-like clinical and histopathological findings offer an attractive model to investigate the mechanisms leading to the precipitation of mineral deposits within elastic fibers and to explore the influence of the genetic background and of the extracellular environment on fibroblast-associated calcifications, thus improving the knowledge on the role of mesenchymal cells on pathologic mineralization. PMID:23467434

  5. Retroperitoneal Castleman's disease mimicking soft tissue tumour.

    PubMed

    Pandya, B; Ghosh, S K; Chude, G; Rajmohan, M V; Narang, R

    2007-08-01

    Castleman's disease is a type of non-neoplastic lymphoproliferative disease having lymph nodal hyperplasia. It has two distinct microscopic types: hyaline-vascular type and plasma cell type. Clinically, it may present either as a solitary mass, most commonly in the mediastinum, or as a multicentric form whose features are generalized lymph-adenopathy, splenomegaly and involvement of other organs like the lungs and kidneys. Here we report a case of isolated retroperitoneal Castleman's disease, which presented as a lump in the iliac fossa in a young female. A clinico-radio-logical diagnosis of retroperitoneal soft tissue tumour was made and the patient underwent complete surgical excision. The exact diagnosis was only obtained at histopathology and there is no evidence of recurrence at six months follow-up. PMID:23132970

  6. Sarcomas of Soft Tissue and Bone.

    PubMed

    Ferrari, Andrea; Dirksen, Uta; Bielack, Stefan

    2016-01-01

    The definition of soft tissue and bone sarcomas include a large group of several heterogeneous subtypes of mesenchymal origin that may occur at any age. Among the different sarcomas, rhabdomyosarcoma, synovial sarcoma, Ewing sarcoma and osteosarcoma are aggressive high-grade malignancies that often arise in adolescents and young adults. Managing these malignancies in patients in this age bracket poses various clinical problems, also because different therapeutic approaches are sometimes adopted by pediatric and adult oncologists, even though they are dealing with the same condition. Cooperation between pediatric oncologists and adult medical oncologists is a key step in order to assure the best treatment to these patients, preferably through their inclusion into international clinical trials. PMID:27595362

  7. CT of soft-tissue neoplasms

    SciTech Connect

    Weekes, R.G.; McLeod, R.A.; Reiman, H.M.; Pritchard, D.J.

    1985-02-01

    The computed tomographic scans (CT) of 84 patients with untreated soft-tissue neoplasms were studied, 75 with primary and nine with secondary lesions. Each scan was evaluated using several criteria: homogeneity and density, presence and type of calcification, presence of bony destruction, involvement of multiple muscle groups, definition of adjacent fat, border definition, and vessel or nerve involvement. CT demonstrated the lesion in all 84 patients and showed excellent anatomic detail in 64 of the 75 patients with primary neoplasms. The CT findings were characteristic enough to suggest the histology of the neoplasm in only 13 lesions (nine lipomas, three hemangiomas, one neurofibroma). No malignant neoplasm had CT characteristics specific enough to differentiate it from any other malignant tumor. However, malignant neoplasms could be differentiated from benign neoplasms in 88% of the cases.

  8. Reconstruction of periorbital soft tissue defects.

    PubMed

    Berli, Jens U; Merbs, Shannath L; Grant, Michael P

    2014-10-01

    Because of the complex anatomy and fine mechanics of the periorbital soft tissues, the reconstruction of this region can be particularly daunting. Through a structured assessment of the defect, based on subunit analysis and thorough understanding of the surgical layers, we believe to allow the reconstructive surgeon to develop an algorithmic approach to these complex problems. The sequela of a suboptimal reconstruction do not only result in an inferior aesthetic result, but also have the potential for long-term functional problems such as epiphora, dry eye, ptosis, eyelid retraction, and thus requiring secondary surgery. There is no better time to aim for a perfect reconstruction than at the time of the initial surgery. In this chapter, we hope to encourage the reader to strengthen and recapitulate these analytical skills and present the most commonly used and studied techniques to help achieve a reproducible functional and aesthetically appealing result. PMID:25397712

  9. Coxsackievirus and Adenovirus Receptor, a Tight Junction Protein, in Peri-Implantation Mouse Embryos.

    PubMed

    Oh, Yeong Seok; Nah, Won Heum; Choi, Bomi; Kim, Seok Hyun; Gye, Myung Chan

    2016-07-01

    To understand the role of Coxsackievirus and adenovirus receptor (CAR), a tight junction (TJ) protein, in peri-implantation embryos, developmental expression of CAR and its role in paracellular permeability were examined in mouse embryos. Splice variants for transmembrane CAR, Car1, Car2, and Car3 mRNA, were expressed from 2-cell, morula, and blastocyst stages onward, respectively, whereas mRNA for soluble CAR was expressed in MII oocytes and 4-cell stage onward. On Western blot, ∼46 kDa CAR proteins were detected in blastocysts. During the 4-cell embryos to morula stage, CAR was gradually concentrated at the contacts between blastomeres. In blastocysts, CAR was expressed at the cell contacts within the inner cell mass as well as in the trophectoderm (TE) where CAR was found together with ZO1 at the apical contacts, suggesting that CAR builds up apical TJs in TE and mediates cell adhesion in TE and inner cell mass. In blastocysts, CAR-blocking antibodies under Ca(2+) switching increased the dextran permeability and decreased the volume of blastocoel and H19 and Cdx2 mRNA, suggesting the pivotal role of CAR in the blastocyst development and paracellular permeability barrier in TE. CAR was expressed in TE of implanting embryos as well as endometrial epithelium, suggesting the involvement of CAR in the interaction between implanting embryos and endometrium. At 5-6 days postcoitum, CAR was expressed together with ZO1 in the primitive endoderm, visceral endoderm, and epiblasts facing the pro-amniotic cavity, suggesting that CAR TJs contribute to the separation of epiblast from the blastocoel and development of the pro-amniotic cavity within epiblasts. PMID:27226313

  10. Soft tissue sarcoma and occupational exposures

    SciTech Connect

    Wingren, G.; Fredrikson, M.; Brage, H.N.; Nordenskjoeld, B.A.; Axelson, O. )

    1990-08-15

    The associations between soft tissue sarcoma (STS) and occupational exposures were studied in a case-referent study in the southeast of Sweden. Exposure information was obtained through mailed questionnaires to 96 cases, 450 randomly selected population referents, and 200 cancer referents. Odds ratios (OR), were calculated for various occupational groups, and particularly, for occupations with potential exposure to chlorinated phenoxy herbicides and chlorophenols. In the analyses based on population referents, increased risks for soft tissue sarcoma were seen for especially gardeners (OR = 4.1), but also railroad workers (OR = 3.1); construction workers with exposure to impregnating agents (OR = 2.3), asbestos (OR = 1.8), or pressure impregnating agents (OR = 1.7); and unspecified chemical workers with potential exposure to phenoxy herbicides and/or chlorophenols (OR = 1.6). A similar pattern appeared when cancer referents were used although the numerical values of the odds ratios became different. A grouping of jobs resulted in Mantel-Haensel OR from 1.5 to 1.9 for farmers and forestry workers, dependent on referents used and even more increased OR for railroad workers and unspecified chemical workers with potential exposure to phenoxy herbicides and chlorophenols. The results of the study confirm rather than refute that phenoxy herbicides and chlorophenols could be of etiologic importance for STS; the high risk for gardeners, although based on a small number of individuals, was unexpected and remains unclear. Also, since other cancers were used as referents, no definite problems of recall bias should obtain in this material. None of the exposed groups had a higher proportion of smokers than the unexposed group.

  11. Association between tumor necrosis factor-alpha G-308A polymorphism and dental peri-implant disease risk

    PubMed Central

    Mo, Yuan-Yuan; Zeng, Xian-Tao; Weng, Hong; Cen, Ying; Zhao, Qian; Wen, Xiujie

    2016-01-01

    Abstract Background: Tumor necrosis factor-alpha (TNF-α) is a potent immune-inflammatory mediator involved in the regulation of bone resorption. The single nucleotide polymorphism G-308A in the TNF-α gene increases the level of this cytokine. This phenomenon is also related to several diseases. Although the association between TNF-α (G-308A) polymorphism and dental peri-implant disease has been investigated, results have remained controversial. Hence, we performed this meta-analysis to provide a comprehensive and systematic conclusion on this topic. Methods: We performed a systematic literature search in PubMed, Embase, ISI Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure until July 2015. A fixed-effect model was established to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). The calculated values were then used to assess the strength of the association between the TNF-α (G-308A) polymorphism and the dental peri-implant disease risk. The heterogeneity between included studies was evaluated with Cochran Q and I2 statistics. Interstudy publication bias was investigated with a funnel plot. Results: Six eligible studies were included in this meta-analysis. The pooled ORs did not reveal a significant relationship between the TNF-α (G-308A) polymorphism and the disease susceptibility. Subgroup analyses in terms of ethnicity and disease type yielded similar results. Conclusion: Our meta-analysis revealed that TNF-α (G-308A) polymorphism was not significantly associated with the risk of dental peri-implant disease. However, further studies with large sample sizes should be performed to verify these results. PMID:27583850

  12. Epidermal growth factor: Porcine uterine luminal epithelial cell migratory signal during the peri-implantation period of pregnancy.

    PubMed

    Jeong, Wooyoung; Jung, Seoungo; Bazer, Fuller W; Song, Gwonhwa; Kim, Jinyoung

    2016-01-15

    The majority of early conceptus mortality in pregnancy occurs during the peri-implantation period, suggesting that this period is important for conceptus viability and the establishment of pregnancy. Successful establishment of pregnancy in all mammalian species depends on the orchestrated molecular events that transpire at the conceptus-uterine interface during the peri-implantation period of pregnancy. This maternal-conceptus interaction is especially crucial in pigs because they have a non-invasive epitheliochorial placentation during a protracted peri-implantation period. During the pre-implantation period of pregnancy, conceptus survival and the establishment of pregnancy depend on the developing conceptus receiving an adequate supply of histotroph which contains a wide range of nutrients and growth factors. Evidence links epidermal growth factor (EGF) to embryogenesis or implantation in various mammalian species. EGF exhibits potential growth-promoting activities on the conceptus and endometrium; however, in the case of pigs, little is known its functions, especially their regulatory mechanisms at the maternal-conceptus interface. EGF receptor (EGFR) mRNA and protein are abundant in endometrial luminal (LE) and glandular (GE) epithelia and conceptus trophectoderm on Days 13-14 of pregnancy, suggesting that EGF provides an autocrine signal to uterine LE and GE just prior to implantation. Therefore, the objectives of this study were to determine: 1) the potential intracellular signaling pathways responsible for the activities of EGF in porcine uterine LE (pLE) cells; and 2) the changes in cellular activities induced by EGF. EGF treatment of pLE cells increased the abundance of phosphorylated (p)-ERK1/2, p-P70RSK and p-RPS6 compared to that for control cells. Furthermore, EGF-stimulated phosphorylation of ERK1/2 MAPK was inhibited in pLE cells transfected with an EGFR siRNA compared with control siRNA-transfected pLE cells. Moreover, EGF stimulated migration of

  13. Age determination of soft tissue hematomas.

    PubMed

    Neumayer, Bernhard; Hassler, Eva; Petrovic, Andreas; Widek, Thomas; Ogris, Kathrin; Scheurer, Eva

    2014-11-01

    In clinical forensic medicine, the estimation of the age of injuries such as externally visible subcutaneous hematomas is important for the reconstruction of violent events, particularly to include or exclude potential suspects. Since the estimation of the time of origin based on external inspection is unreliable, the aim of this study was to use contrast in MRI to develop an easy-to-use model for hematoma age estimation. In a longitudinal study, artificially created subcutaneous hematomas were repetitively imaged using MRI over a period of two weeks. The hemorrhages were created by injecting autologous blood into the subcutaneous tissue of the thigh in 20 healthy volunteers. For MRI, standard commercially available sequences, namely proton-density-weighted, T2 -weighted and inversion recovery sequences, were used. The hematomas' MRI data were analyzed regarding their contrast behavior using the most suitable sequences to derive a model allowing an objective estimation of the age of soft tissue hematomas. The Michelson contrast between hematoma and muscle in the proton-density-weighted sequence showed an exponentially decreasing behavior with a dynamic range of 0.6 and a maximum standard deviation of 0.1. The contrast of the inversion recovery sequences showed increasing characteristics and was hypointense for TI = 200ms and hyperintense for TI =1000ms. These sequences were used to create a contrast model. The cross-validation of the model finally yielded limits of agreement for hematoma age determination (corresponding to ±1.96 SD) of ±38.7h during the first three days and ±54 h for the entire investigation period. The developed model provides lookup tables which allow for the estimation of a hematoma's age given a single contrast measurement applicable by a radiologist or a forensic physician. This is a first step towards an accurate and objective dating method for subcutaneous hematomas, which will be particularly useful in child abuse. PMID:25208978

  14. Soft Tissue Augmentation with Silk Composite Graft

    PubMed Central

    Park, Yong-Tae; Kweon, Hae Yong; Kim, Seong-Gon

    2014-01-01

    Purpose: The objective of this study was to evaluate the interaction between 4-hexylresorcinol (4HR) and antibody as that affects the performance of a silk-4HR combination graft for soft tissue augmentation in an animal model. Methods: The silk graft materials consisted of four types: silk+10% tricalcium phosphate (TCP) (ST0), silk+10% TCP+1% 4HR (ST1), silk+10% TCP+3% 4HR (ST3), and silk+10% TCP+6% 4-HR (ST6). The antibody binding assay tested the 4HR effect and scanning electron microscopic (SEM) exam was done for silk grafts. The animal experiment used a subcutaneous pocket mouse model. The graft – SH0 or SH1 or SH3 or SH6 – was placed in a subcutaneous pocket. The animals were killed at one, two, and four weeks, postoperatively. The specimens were subjected to histological analysis and lysozyme assay. Results: Groups with 4HR applied showed lower antibody binding affinity to antigen compared to groups without 4HR. In the SEM examination, there was no significant difference among groups. Histological examinations revealed many foreign body giant cells in ST0 and ST1 group at four weeks postoperatively. Both ST3 and ST6 groups developed significantly lower levels of giant cell values compared to ST0 and ST1 groups (P <0.001) at four weeks postoperatively. In the lysozyme assay, the ST1 and ST3 groups showed denser signals than the other groups. Conclusion: 4HR combined silk implants resulted in high levels of vascular and connective tissue regeneration. PMID:27489833

  15. Biomechanical characterization of soft tissue injuries

    NASA Astrophysics Data System (ADS)

    Winnem, Andreas Meyer; Randeberg, Lise Lyngsnes; Larsen, Eivind L. P.; Lilledahl, Magnus B.; Haaverstad, Rune; Haugen, Olav A.; Skallerud, Bjørn; Svaasand, Lars O.

    2007-02-01

    Determining the cause of an injury and the force behind the impact may be of crucial importance in a court case. For non-penetrating soft tissue injuries there is a lack of information available in the literature. In this study controlled bruises were inflicted on an anesthetized pig by high speed, low-weight paintball projectiles (diameter 17.1 mm, weight 3.15 g). The speed of the object and the impact itself were monitored using a high speed camera. Punch biopsies (5 mm) were collected from the injury sites. A red and purple ring with a diameter of 1.5 cm appeared on the skin within 30 seconds after the paintball impact. The ring was visually fully established after 5-10 minutes. Numerical finite element simulations performed with ABAQUSExplicit showed a build up of shear stresses in the skin where the ring formed. Biopsies demonstrated severe dermal vessel damage in the same area. It is concluded that considerable shear stresses during the impact will create dermal vessel damage and thereby cause a visible bruise. Larger forces are required for compressive stresses to inflict equivalent vascular damage.

  16. Adjuvant chemotherapy for soft tissue sarcoma.

    PubMed

    Casali, Paolo G

    2015-01-01

    Adjuvant chemotherapy is not standard treatment in soft tissue sarcoma (STS). However, when the risk of relapse is high, it is an option for shared decision making with the patient in conditions of uncertainty. This is because available evidence is conflicting, even if several randomized clinical trials have been performed for 4 decades and also have been pooled into meta-analyses. Indeed, available meta-analyses point to a benefit in the 5% to 10% range in terms of survival and distant relapse rate. Some local benefit also was suggested by some trials. Placing chemotherapy in the preoperative setting may help gain a local advantage in terms of the quality of surgical margins or decreased sequelae. This may be done within a personalized approach according to the clinical presentation. Attempts to personalize treatment on the basis of the variegated pathology and molecular biology of STS subgroups are ongoing as well, according to what is done in the medical treatment of advanced STS. Thus, decision making for adjuvant and neoadjuvant indications deserves personalization in clinical research and in clinical practice, taking profit from all multidisciplinary clinical skills available at a sarcoma reference center, though with a degree of subjectivity because of the limitations of available evidence. PMID:25993233

  17. Clinical, Radiographic and Microbiological Evaluation of High Level Laser Therapy, a New Photodynamic Therapy Protocol, in Peri-Implantitis Treatment; a Pilot Experience

    PubMed Central

    Caccianiga, Gianluigi; Rey, Gerard; Baldoni, Marco; Paiusco, Alessio

    2016-01-01

    Aim. Endosseous implants are widely used to replace missing teeth but mucositis and peri-implantitis are the most frequent long-term complications related with dental implants. Removing all bacterial deposits on contaminated implant surface is very difficult due to implant surface morphology. The aim of this study was to evaluate the bactericidal potential of photodynamic therapy by using a new high level laser irradiation protocol associated with hydrogen peroxide in peri-implantitis. Materials and Methods. 10 patients affected by peri-implantitis were selected for this study. Medical history, photographic documentation, periodontal examination, and periapical radiographs were collected at baseline and 6 months after surgery. Microbiological analysis was performed with PCR Real Time. Each patient underwent nonsurgical periodontal therapy and surgery combined with photodynamic therapy according to High Level Laser Therapy protocol. Results. All peri-implant pockets were treated successfully, without having any complication and not showing significant differences in results. All clinical parameters showed an improvement, with a decrease of Plaque Index (average decrease of 65%, range 23–86%), bleeding on probing (average decrease of 66%, range 26–80%), and probing depth (average decrease of 1,6 mm, range 0,46–2,6 mm). Periapical radiographs at 6 months after surgery showed a complete radiographic filling of peri-implant defect around implants treated. Results showed a decrease of total bacterial count and of all bacterial species, except for Eikenella corrodens, 6 months after surgery. Conclusion. Photodynamic therapy using HLLT appears to be a good adjunct to surgical treatment of peri-implantitis. PMID:27379251

  18. Primary oral squamous cell carcinoma arising around dental osseointegrated implants mimicking peri-implantitis.

    PubMed

    Eguia del Valle, Asier; Martínez-Conde Llamosas, Rafael; López Vicente, José; Uribarri Etxebarria, Agurne; Aguirre Urizar, José Manuel

    2008-08-01

    Prosthodontic rehabilitation using dental implants has become a common practice in dentistry at the present time. The number of complications related to dental osseointegrated implants has increased according to the generalization of its use along the last decade. Among the most common of these complications are chronic inflammatory conditions affecting both hard and soft tissues around dental implants. Although severe complications are uncommon, in recent years several cases of oral squamous cell carcinoma adjacent to dental implants have been published. In this paper we present a new unusual case of primary oral squamous cell carcinoma arising around a dental fixed prosthesis over osseointegrated implants in a 76 male patient with no previous history of malignance and no risk factors related to oral cancer. PMID:18667981

  19. Treatment Options for Adult Soft Tissue Sarcoma

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  20. Treatment Option Overview (Adult Soft Tissue Sarcoma)

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  1. Stages of Adult Soft Tissue Sarcoma

    MedlinePlus

    ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ... superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle ...

  2. Isolated Limb Perfusion of Melphalan With or Without Tumor Necrosis Factor in Treating Patients With Soft Tissue Sarcoma of the Arm or Leg

    ClinicalTrials.gov

    2012-03-14

    Stage IVB Adult Soft Tissue Sarcoma; Stage IIB Adult Soft Tissue Sarcoma; Stage IIC Adult Soft Tissue Sarcoma; Recurrent Adult Soft Tissue Sarcoma; Stage IVA Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma

  3. Soft tissue invasion of papillary thyroid carcinoma.

    PubMed

    Lin, Jen-Der; Hsueh, Chuen; Chao, Tzu-Chieh

    2016-08-01

    Extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) is common and clinical presentation can vary from minimal to extensive locoregional involvement. Although PTC is generally considered the most benign among all thyroid carcinomas, it may present with local invasion with poor prognosis. Our retrospective study involved 3267 PTC patients undergoing regular follow-up at Chang Gung Medical Center in Linkou, Taiwan. Among them, 269 were PTC cases with ETE, having tumors greater than 1 cm in size and treated with total or complete thyroidectomy with or without lymph node dissection for which the follow-up period was over 10 years. The mean age of 269 cases was 46.8 ± 15.1 (range 11-83 years) years. The number of females was 204 (75.8 %). Patients were categorized into minimal ETE (175 cases) and extensive ETE (94 cases) groups according to surgical findings and pathological reports. Mean follow-up period was 13.3 ± 5.5 (range 0.2-29.3) years, during which 28 (10.4 %) patients died of thyroid cancer; and 63 (23.4 %) of all-cause mortality. Multivariate analysis showed that age, gender, extensive ETE, and lymph node metastasis had a statistically significant effect on thyroid cancer mortality. Survival rates were significantly different between minimal ETE and extensive ETE groups (p < 0.0001). In conclusion, perithyroidal soft tissue involvement by PTC is an important factor that determines patient prognosis and a closer follow-up and more aggressive treatment is necessary for patients who are old, male, extensive ETE, and with lymph node involvement. PMID:27154220

  4. Optical-Based Analysis of Soft Tissue Structures.

    PubMed

    Goth, Will; Lesicko, John; Sacks, Michael S; Tunnell, James W

    2016-07-11

    Fibrous structures are an integral and dynamic feature of soft biological tissues that are directly related to the tissues' condition and function. A greater understanding of mechanical tissue behavior can be gained through quantitative analyses of structure alone, as well as its integration into computational models of soft tissue function. Histology and other nonoptical techniques have traditionally dominated the field of tissue imaging, but they are limited by their invasiveness, inability to provide resolution on the micrometer scale, and dynamic information. Recent advances in optical modalities can provide higher resolution, less invasive imaging capabilities, and more quantitative measurements. Here we describe contemporary optical imaging techniques with respect to their suitability in the imaging of tissue structure, with a focus on characterization and implementation into subsequent modeling efforts. We outline the applications and limitations of each modality and discuss the overall shortcomings and future directions for optical imaging of soft tissue structure. PMID:27420574

  5. What Are the Risk Factors for Soft Tissue Sarcoma?

    MedlinePlus

    ... soft tissue sarcoma. Exposure to dioxin and to herbicides that contain phenoxyacetic acid at high doses (such ... known for certain. There is no evidence that herbicides (weed killers) or insecticides, at levels encountered by ...

  6. Do We Know What Causes Soft Tissue Sarcomas?

    MedlinePlus

    ... that some of these risk factors affect the DNA of cells in the soft tissues. Researchers have ... great progress in understanding how certain changes in DNA can cause normal cells to become cancerous. Our ...

  7. Doxorubicin With Upfront Dexrazoxane for the Treatment of Advanced or Metastatic Soft Tissue Sarcoma

    ClinicalTrials.gov

    2016-07-11

    Sarcoma, Soft Tissue; Soft Tissue Sarcoma; Undifferentiated Pleomorphic Sarcoma; Leiomyosarcoma; Liposarcoma; Synovial Sarcoma; Myxofibrosarcoma; Angiosarcoma; Fibrosarcoma; Malignant Peripheral Nerve Sheath Tumor; Epithelioid Sarcoma

  8. Impact of crestal and subcrestal implant placement in peri-implant bone: A prospective comparative study

    PubMed Central

    Pellicer-Chover, Hilario; Peñarrocha-Diago, María; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Agustín-Panadero, Rubén

    2016-01-01

    Background To assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up. Material and Methods Twenty-six patients with a single hopeless tooth were recruited in the Oral Surgery Unit (Valencia University, Valencia, Spain). The patients were randomized into two treatment groups: group A (implants placed at crestal level) or group B (implants placed at subcrestal level). Control visits were conducted by a trained clinician at the time of implant placement and 12 months after loading. A previously established standard protocol was used to compile general data on all patients (sex and age, implant length and diameter, and brushing frequency). Implant success rate, peri-implant bone loss and the treatment of the exposed implant surface were studied. The level of statistical significance was defined as 5% (α=0.05). Results Twenty-three patients (8 males and 15 females, mean age 49.8±11.6 years, range 28-75 years) were included in the final data analyses, while three were excluded. All the included subjects were nonsmokers with a brushing frequency of up to twice a day in 85.7% of the cases. The 23 implants comprised 10 crestal implants and 13 subcrestal implants. After implant placement, the mean bone position with respect to the implant platform in group A was 0.0 mm versus 2.16±0.88 mm in group B. After 12 months of follow-up, the mean bone positions were -0.06±1.11 mm and 0.95±1.50 mm, respectively - this representing a bone loss of 0.06±1.11 mm in the case of the crestal implants and of 1.22±1.06 mm in the case of the subcrestal implants (p=0.014). Four crestal implants and 5 subcrestal implants presented peri-implant bone levels below the platform, leaving a mean exposed treated surface of 1.13 mm and 0.57 mm, respectively. The implant osseointegration success rate at 12 months was 100% in both groups. Conclusions Within the limitations of this study, bone loss was found to be greater in

  9. Management of soft tissue defects of the hand.

    PubMed

    Yannascoli, Sarah M; Thibaudeau, Stephanie; Levin, L Scott

    2015-06-01

    Soft tissue coverage of the hand remains a challenging problem to the hand surgeon, but advances in the field of microsurgery have provided improved thin, pliable, durable flaps that offer cosmetic reconstructive options. The reconstructive elevator is poised to replace the reconstructive ladder, thereby allowing early reconstruction by the best available option. This reviews focus on the variety of pedicled, free fasciocutaneous, and venous flaps available for successful soft tissue coverage of the hand. PMID:25936734

  10. A case of Apophysomyces trapeziformis necrotizing soft tissue infection.

    PubMed

    Echaiz, Jose F; Burnham, Carey-Ann D; Bailey, Thomas C

    2013-12-01

    Mucormycosis is a rare and devastating disease. Apophysomyces trapeziformis is an environmental mold that was recently implicated in several cases of cutaneous and soft tissue mucormycosis in victims of a tornado in Joplin, Missouri. Here, we report a case of Apophysomyces trapeziformis necrotizing soft tissue infection in a resident of Joplin 10 months after the disaster and without preceding trauma. Aspects of histological and microbiological diagnosis are also reviewed. PMID:23891642