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Sample records for cast-to implant components

  1. Component engineering for an implantable system.

    PubMed

    Wang, Qingtian; Yambe, Tomoyuki; Shiraishi, Yasuyuki; Esashi, Masayoshi; Haga, Youichi; Yoshizawa, Makoto; Sato, Fumihiro; Matsuki, Hidetoshi; Imachi, Kou; Abe, Yusuke; Sasada, Hiroshi; Nitta, Shin-Ichi

    2004-10-01

    Component engineering is important for the development of implantable-type rotary blood pumps (RP). The authors are conducting elementary development of an implantable artificial heart. A sensor system detects information in the living body. An automatic control system performs the drive control. Energy is provided by a transcutaneous energy transmission system (TETS). Various artificial hearts are being created. Miniaturization resulting from an increase in operating frequency is planned. A vibrating flow pump (VFP) has a reduced size of pumping chamber because of the high-speed reciprocating movement. Undulation pump ventricular assist devices (UPVAD) are small, lightweight rotary pumps. VFPs are useful in the medical treatment of multiple organ failure (MOF). UPVADs are planned to be permanent-use RPs. The purposes of these two artificial hearts differ, although they have a common component. The authors are developing TETS by using amorphous fibers, making efficient power transmission possible. Control information input from a micro or nano sensor is realized. A control algorithm has been developed and baroreflex control has been successful. Artificial heart development, fully exploiting component engineering, continues.

  2. 78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-25

    ... COMMISSION Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof..., Software, Implants, and Components Thereof, DN 2945; the Commission is soliciting comments on any public... devices, software, implants, and components thereof. The complaint names as respondents Stanmore...

  3. Hip resurfacing arthroplasty complicated by mismatched implant components

    PubMed Central

    Calistri, Alessandro; Campbell, Patricia; Van Der Straeten, Catherine; De Smet, Koen Aimè

    2017-01-01

    Metal-on-metal hip resurfacing has gained popularity as a feasible treatment option for young and active patients with hip osteoarthritis and high functional expectations. This procedure should only be performed by surgeons who have trained specifically in this technique. Preoperative planning is essential for hip resurfacing in order to execute a successful operation and preview any technical problems. The authors present a case of a man who underwent a resurfacing arthroplasty for osteoarthritis of the left hip that was complicated by mismatched implant components that were revised three days afterwards for severe pain and leg length discrepancy. Such mistakes, although rare, can be prevented by educating operating room staff in the size and colour code tables provided by the companies on their prostheses or implant boxes. PMID:28361022

  4. Hip resurfacing arthroplasty complicated by mismatched implant components.

    PubMed

    Calistri, Alessandro; Campbell, Patricia; Van Der Straeten, Catherine; De Smet, Koen Aimè

    2017-03-18

    Metal-on-metal hip resurfacing has gained popularity as a feasible treatment option for young and active patients with hip osteoarthritis and high functional expectations. This procedure should only be performed by surgeons who have trained specifically in this technique. Preoperative planning is essential for hip resurfacing in order to execute a successful operation and preview any technical problems. The authors present a case of a man who underwent a resurfacing arthroplasty for osteoarthritis of the left hip that was complicated by mismatched implant components that were revised three days afterwards for severe pain and leg length discrepancy. Such mistakes, although rare, can be prevented by educating operating room staff in the size and colour code tables provided by the companies on their prostheses or implant boxes.

  5. Ion implantation of highly corrosive electrolyte battery components

    DOEpatents

    Muller, R.H.; Zhang, S.

    1997-01-14

    A method of producing corrosion resistant electrodes and other surfaces in corrosive batteries using ion implantation is described. Solid electrically conductive material is used as the ion implantation source. Battery electrode grids, especially anode grids, can be produced with greatly increased corrosion resistance for use in lead acid, molten salt, and sodium sulfur. 6 figs.

  6. Ion implantation of highly corrosive electrolyte battery components

    DOEpatents

    Muller, Rolf H.; Zhang, Shengtao

    1997-01-01

    A method of producing corrosion resistant electrodes and other surfaces in corrosive batteries using ion implantation is described. Solid electrically conductive material is used as the ion implantation source. Battery electrode grids, especially anode grids, can be produced with greatly increased corrosion resistance for use in lead acid, molten salt, end sodium sulfur.

  7. Principal component analysis: a novel analysis to evaluate the characteristics of osseointegration of different implant surfaces.

    PubMed

    Jimbo, Ryo; Fernandez-Rodriguez, Julia; Sul, Young-Taeg; Johansson, Carina B

    2011-10-01

    To apply a new statistical method (principle component analysis; PCA) to evaluate osseointegration. Two different commercially available implants were selected for the study. Twenty implants, 10 of each type, were placed in the rabbit tibiae (n = 10). The fluorochromes (FLCs) alizarin complexone and calcein green were administered after 20 days and 4 days before sacrifice for labeling. On the day of implantation and retrieval (6 weeks), implant stability was measured with a resonance frequency analyzer (RFA). The retrieved samples were ground sectioned for histomorphometric and FLC quantification. The collected data were analyzed by a PCA software program (Qlucore Omics Explorer, Lund, Sweden) to explore and determine the correlation between different study variables and to analyze the differences between different implants. The RFA presented no significant differences at either time point. The bone-to-implant contact was significantly higher for the TiUnite (NobelBiocare, Gothenburg, Sweden); however, the bone area and FLC quantification showed higher values for the Osseotite (3i Implant Innovation, FL). Consistent with these results, the PCA indicated a strong correlation between TiUnite and high bone-to-implant contact values and between Osseotite and high bone area and FLC values. No correlation between RFA and the biological responses were found. The application of the PCA analysis may help interpret and correlate results obtained from numerous evaluations.

  8. Molecular ion implantation technique for obtaining the same depth profile for the component atoms

    SciTech Connect

    Ishikawa, Junzo; Tsuji, Hiroshi; Mimura, Masakazu; Gotoh, Yasuhito

    1996-12-31

    The molecular ion implantation, in which the ions of polyatomic molecule are used as an implantation particle, is expected to have two main advantages: (1) obtaining the similar depth profiles of implanted component atoms of different elements at a single implantation, and (2) achieving simultaneous implantation of different atoms at the same position. In this paper, we have showed these advantages by an analytical estimation of the projected ranges for each implanted atoms of a polyatomic molecule, and then, by the computer simulation by TRIM. In addition, the experimental results obtained by SIMS were also presented. As for the evaluation of depth profiles, the overlap areas between two depth distributions were calculated by a numerical integration as a degree of the similarity between two depth profiles of different atoms. As a result, the projected ranges and overlap areas showed that depth profiles are almost the same in a usual implantation energy range, except of hydrogen due to the lack of neutron in the nucleus. For the simple evaluation for the similarity of two depth profiles, a factor S was proposed instead of the overlap area.

  9. In vitro measurement of temperature changes during implantation of cemented glenoid components

    PubMed Central

    Raiss, Patric; Pape, Guido; Jäger, Sebastian; Bitsch, Rudi; Rickert, Markus

    2010-01-01

    Background and purpose It is unclear whether the increase in temperature during cement curing may cause osteonecrosis, leading to loosening of the glenoid component in shoulder arthroplasty. We therefore analyzed the temperature during implantation of cemented glenoid implants. Methods 8 keeled and 8 pegged glenoids were implanted in standardized fashion in 8 pairs of scapulas. Temperature and pressure sensors were implanted at the bone-cement interface in the glenoid. Real-time measurements were made of temperature and pressure within the glenoid vault. Results In no case was the temperature reached high enough to endanger the surrounding bone. The mean increase in temperature was 5° (0.5–6.9) in the keeled group and 2.7° (1.7–3.6) in the pegged group. The mean maximum pressure in the keeled group was 50 kPa (20–100) and in the pegged group it was 113 kPa (60–181). Both differences were statistically significant. Interpretation The temperatures that occur during implantation of cemented components are low and probably not high enough to cause osteonecrosis in the surrounding bone. PMID:20367412

  10. Development and evaluation of components for a totally implantable artificial heart system.

    PubMed

    Taenaka, Y; Masuzawa, T; Tatsumi, F; Anai, H; Toda, K; Akagi, H; Nakatani, T; Baba, Y; Fya, K; Wakisaka, Y

    1994-01-01

    The authors have been developing an electrohydraulic (EH) artificial heart system for total implantation. This system consists of intrathoracic ventricles, an abdominally placed EH actuator, flexible silicone oil conduits, externally coupled transcutaneous energy transfer (TET) system, transcutaneous optical telemetry (TOT) system, internal battery, and internal control drive unit. Fitting was evaluated in chronic animal experiments as a pneumatic system in 11 goats weighing 55.2 +/- 4.2 kg and 3 calves of 52.3 +/- 1.2 kg. The longest survival time in calves was 111 days, and that in goats was 51 days. The assembled EH pump was implanted in two goats of 49 and 50 kg as an acute experiment, and 4.2-6.7 L/min of cardiac output was maintained. For the TET system, an internal coil 3 cm in diameter was implanted to make an arch covered by skin. Electric energy was transmitted from the external to the internal coil, and energy of about 20 W was carried through wires to an external load. The DC-to-DC efficiency of the system was 76-83% for 40 days. The TOT system with internal light emitting diodes and external photodiodes also was evaluated in a goat. Disalignment of up to 12 mm was tolerated. Although more improvement is necessary, most of the components showed characteristics desirable for a totally implantable system.

  11. Power loss measurement of implantable wireless power transfer components using a Peltier device balance calorimeter

    NASA Astrophysics Data System (ADS)

    Leung, Ho Yan; Budgett, David M.; Taberner, Andrew; Hu, Patrick

    2014-09-01

    Determining heat losses in power transfer components operating at high frequencies for implantable inductive power transfer systems is important for assessing whether the heat dissipated by the component is acceptable for implantation and medical use. However, this is a challenge at high frequencies and voltages due to limitations in electronic instrumentation. Calorimetric methods of power measurement are immune to the effects of high frequencies and voltages; hence, the measurement is independent of the electrical characteristics of the system. Calorimeters have been widely used to measure the losses of high power electrical components (>50 W), however it is more difficult to perform on low power components. This paper presents a novel power measurement method for components dissipating anywhere between 0.2 W and 1 W of power based on a heat balance calorimeter that uses a Peltier device as a balance sensor. The proposed balance calorimeter has a single test accuracy of ±0.042 W. The experimental results revealed that there was up to 35% difference between the power measurements obtained with electrical methods and the proposed calorimeter.

  12. Tribological performance of the biological components of synovial fluid in artificial joint implants

    NASA Astrophysics Data System (ADS)

    Ghosh, Subir; Choudhury, Dipankar; Roy, Taposh; Moradi, Ali; Masjuki, H. H.; Pingguan-Murphy, Belinda

    2015-08-01

    The concentration of biological components of synovial fluid (such as albumin, globulin, hyaluronic acid, and lubricin) varies between healthy persons and osteoarthritis (OA) patients. The aim of the present study is to compare the effects of such variation on tribological performance in a simulated hip joint model. The study was carried out experimentally by utilizing a pin-on-disk simulator on ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoP) hip joint implants. The experimental results show that both friction and wear of artificial joints fluctuate with the concentration level of biological components. Moreover, the performance also varies between material combinations. Wear debris sizes and shapes produced by ceramic and polyethylene were diverse. We conclude that the biological components of synovial fluid and their concentrations should be considered in order to select an artificial hip joint to best suit that patient.

  13. Tribological performance of the biological components of synovial fluid in artificial joint implants.

    PubMed

    Ghosh, Subir; Choudhury, Dipankar; Roy, Taposh; Moradi, Ali; Masjuki, H H; Pingguan-Murphy, Belinda

    2015-08-01

    The concentration of biological components of synovial fluid (such as albumin, globulin, hyaluronic acid, and lubricin) varies between healthy persons and osteoarthritis (OA) patients. The aim of the present study is to compare the effects of such variation on tribological performance in a simulated hip joint model. The study was carried out experimentally by utilizing a pin-on-disk simulator on ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoP) hip joint implants. The experimental results show that both friction and wear of artificial joints fluctuate with the concentration level of biological components. Moreover, the performance also varies between material combinations. Wear debris sizes and shapes produced by ceramic and polyethylene were diverse. We conclude that the biological components of synovial fluid and their concentrations should be considered in order to select an artificial hip joint to best suit that patient.

  14. Tribological performance of the biological components of synovial fluid in artificial joint implants

    PubMed Central

    Ghosh, Subir; Choudhury, Dipankar; Roy, Taposh; Moradi, Ali; Masjuki, H H; Pingguan-Murphy, Belinda

    2015-01-01

    The concentration of biological components of synovial fluid (such as albumin, globulin, hyaluronic acid, and lubricin) varies between healthy persons and osteoarthritis (OA) patients. The aim of the present study is to compare the effects of such variation on tribological performance in a simulated hip joint model. The study was carried out experimentally by utilizing a pin-on-disk simulator on ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoP) hip joint implants. The experimental results show that both friction and wear of artificial joints fluctuate with the concentration level of biological components. Moreover, the performance also varies between material combinations. Wear debris sizes and shapes produced by ceramic and polyethylene were diverse. We conclude that the biological components of synovial fluid and their concentrations should be considered in order to select an artificial hip joint to best suit that patient. PMID:27877822

  15. Vibrational analysis of implants and tissues: Calibration and mechanical spectroscopy of multi-component materials.

    PubMed

    Shah, Ruchit G; DeVore, Dale; Pierce, Mark C; Silver, Frederick H

    2017-06-01

    Several new methods have been used to non-destructively evaluate the mechanical properties of materials and tissues including magnetic resonance elastography, ultrasound elastography, optical coherence elastography, and various forms of vibrational analysis. One of the limitations of using these methods is the need to establish a relationship between the modulus measured using each new technique and moduli measured using well-established techniques such as constant rate-of-strain and incremental stress-strain curves. In addition, there are no available methods for analyzing the mechanical properties of the individual components of multi-component materials. In this article, we present data showing that there is a strong correlation (correlation coefficient >0.9) between the modulus measured using classical uniaxial tensile incremental stress-strain tests and those made using a combination of optical coherence tomography and vibrational analysis. Beyond this, we demonstrate that the moduli of the major structural components of pig skin can be measured using this technique. These results suggest that optical coherence tomography in concert with vibrational analysis can be used to measure the moduli of biological and implant materials without having to determine Poisson's ratio. In addition, each of the moduli of the major fibrous components of pig skin can be measured concurrently using this technique. These results may be useful in the characterization of synthetic implants and tissue derived materials without requiring removal of one or more components that are to be characterized. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1666-1671, 2017. © 2017 Wiley Periodicals, Inc.

  16. Marker-based technique for visualizing radiolucent implant components in radiographic imaging.

    PubMed

    Lam-Tin-Cheung, Kimberley; Yuan, Xunhua; Nikolov, Hristo N; Lanting, Brent A; Naudie, Douglas D; Teeter, Matthew G

    2017-09-01

    Radiography is the predominant imaging modality used for the in-vivo analysis of orthopaedic implants. A major disadvantage of radiography is that the articulating joint components that are composed of radiolucent polyethylene cannot be directly visualized. Current strategies attempt to circumvent this limitation by estimating component positions and simplifying the joint system, however, these approaches lead to a number of associated errors. Thus, this study provides a method to enable the visualization of the polyethylene component of total knee replacements in radiographic images. This was achieved through the repeatable insertion of markers and accompanying registration process, which were evaluated in this study for reproducibility and accuracy. An insertion guide was developed to insert tantalum beads into polyethylene tibial surface liners. The bead-inserted liners were micro-CT scanned to obtain 3D surface geometries. An in-vivo mimicking phantom RSA experiment was then used to test the 3D to 2D registration process. The guide positioned the beads consistently to ±0.21 mm. The 3D to 2D registration demonstrated a repeatability of -0.014 ± 0.008 mm. Registration of different bead-inserted tibial liners to the phantom revealed an average error of 0.026 ± 0.047 mm for this visualization method. This visualization approach provides greatly improved registration and inter-component measurements than current alternative strategies. This process is suitable for a number of other joints and would greatly benefit procedures that analyze component interactions and implant performance over time. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2017-2022, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  17. Robot-assisted implantation improves the precision of component position in minimally invasive TKA.

    PubMed

    Kim, Sang-Min; Park, Youn-Soo; Ha, Chul-Won; Lim, Seung-Jae; Moon, Young-Wan

    2012-09-01

    Minimally invasive and robot-assisted procedures have potential advantages when used for total knee arthroplasty (TKA). The purpose of this cadaveric study was to examine whether robot-assisted minimally invasive procedures improve TKA alignment after modifying the robotic techniques and instruments. Total knee arthroplasties were performed on 10 pairs of fresh cadaveric femora. Ten knees were replaced using the robot-assisted minimally invasive technique and 10 using the conventional minimally invasive technique. After prosthesis implantation, limb and prosthesis alignments were investigated by measuring mechanical axis deviation, femoral and tibial sagittal and coronal inclination, and femoral rotational alignment with 3-dimensional computed tomography scans. Postoperative alignment accuracy of the implanted prostheses was better in the robot-assisted minimally invasive TKA group than in the conventional minimally invasive TKA group as judged by the rotational alignment of the femoral component (0.7°±″.3° vs 3.6°±2.2°, respectively) and the tibial component sagittal angle (7.8°±1.1° vs 5.5°±3.6°, respectively). One sagittal inclination outlier for the tibial side existed in the robotic minimally invasive TKA group, and 2 outliers for the mechanical axis, 2 for the tibial side sagittal inclination, and 2 for the femoral rotational alignment existed in the conventional minimally invasive TKA group. Higher implanted prostheses accuracy and fewer outliers in postoperative radiographic alignments can be attained with robot-assisted TKA. Minimally invasive TKA in combination with an improved robot-assisted technique is an alternative option to compensate for the shortcomings of conventional minimally invasive TKA. Copyright 2012, SLACK Incorporated.

  18. "Solar-Wind-Rich" Howardite: True Regolith vs. CM-Implanted Components

    NASA Technical Reports Server (NTRS)

    Cartwright, Julia A.; Mittlefehldt, D. W.; Herrin, J. S.; Hermann, S.; Ott, U.

    2011-01-01

    Howardite, eucrite and diogenite meteorites (collectively HED) likely originate from asteroid 4-Vesta [1], one of two asteroids targeted by NASA s Dawn mission. Many howardites (polymict breccias of E and D material) contain "regolithic" features, including impact-melt clasts, fragmental breccia clasts, and carbonaceous chondrite fragments. True regolithic nature can be determined through noble gas analysis, as Solar Wind (SW) is implanted into the upper-most surfaces of solar system bodies. Whilst previous work [2] suggested that high siderophile element contents (e.g. Ni of 300-1200 g/g) were regolith indicators, we found no obvious correlation between SW and these indicators in our initial howardite noble gas analyses [3]. We observed CM-like fragments in a number of our howardites, whose textures suggest late addition to the breccia assemblage [4]. As typical CMs contain mixtures of SW (in matrix) and planetary (in clasts) components [5], we investigate the dominance of such components in SW-rich howardites. This will help deter-mine the extent of implanted SW in HED grains vs. SW and planetary gases from CM fragments, and allow better understanding of regolith processes

  19. An evaluation of fit in osseointegrated implant components using torque/turn analysis.

    PubMed

    Wicks, R A; deRijk, W G; Windeler, A S

    1994-12-01

    The accurate and passive fit of dental prostheses supported by endosseous implants is of primary importance in securing long-term restorative success. In the clinical setting, adequate visual and radiographic assessment of joined implant components can be limited. Mechanical engineering principles show a linear relationship between tightening and the degree of rotation of a precision bolted assembly. At a constant torque, with certain variables controlled, a threaded fastener should return to the same rotational end position on repeated tightenings. This study evaluated the terminal screw positions of joined implant components as a potential aid to the clinician in confirming the fit of a fixed and removable prosthesis. There were three areas of experimental inquiry: (1) How reproducible are the various clinical means by which torque is applied to the fastening screws, both in absolute and relative value? (2) How reproducible are the rotational end positions of the gold (attachment) and titanium (center) screws when a controlled torque is applied? (3) Do changes in screw position occur as a function of the magnitude of artificially introduced discrepancies? Three different torque delivery devices were evaluated: a hand-held screwdriver (DIB 048; NobelpharmaUSA, Chicago, IL), a manual torque wrench (DIA 250; NobelpharmaUSA), and an electronic Torque Controller (DEA 020; NobelpharmaUSA), using a calibrated torque measuring dynamometer (Magtrol, Inc, Buffalo, NY). The reproducibility of turning limits were determined for both the titanium and gold screws contained in five Brånemark implant assemblies. Each assembly was subjected to six trials, tightening to recommended torque. The position of each screw head was recorded with a special scribe on acetate sheets and transferred to graph paper. Five implant assemblies were invested in dental stone within a die form mold. A casting was made supported by three implant analogues. Stainless steel shims of 12.7-microns, 25

  20. Total ankle replacement with use of a new three-component implant.

    PubMed

    Rippstein, Pascal F; Huber, Martin; Coetzee, J Chris; Naal, Florian D

    2011-08-03

    Total ankle arthroplasty has evolved over the past decade, and newer three-component implants have demonstrated favorable clinical results and improved survivorship. The present study analyzed the clinical and radiographic results of the first 240 total ankle arthroplasties performed by the authors with one of these new three-component prostheses. Two hundred and forty consecutive primary total ankle arthroplasties were performed in 233 patients (115 women and 118 men; mean age, 61.6 years) between November 2003 and October 2007 with the Mobility prosthesis. Intraoperative and postoperative complications, reoperations, and failures were recorded. The American Orthopaedic Foot & Ankle Society hindfoot score and a visual analog scale score assessment of pain were determined at each follow-up visit. Range of ankle motion was measured on functional radiographs, and the radiographs were studied to assess component positioning, radiolucencies, new bone formation, and periprosthetic bone cysts. Two hundred and thirty-three of the arthroplasties were available for follow-up at least one year after surgery. The mean duration of follow-up was 32.8 ± 15.3 months. There were ten intraoperative complications (4.2%) and twenty postoperative complications (8.6%). A reoperation was necessary in eighteen ankles (7.7%). Five arthroplasties (2.1%) failed at a mean of twenty-seven months after surgery. The mean American Orthopaedic Foot & Ankle Society hindfoot score improved from 48.2 to 84.1 points (p < 0.001). The mean pain level decreased from 7.7 to 1.7 points (p < 0.001). The mean total range of ankle motion improved from 19.8° to 21.9° (p < 0.001). The tibial component had a mean of 2.1° of varus and a mean posterior slope of 6.0° relative to the tibial axis. The prevalence of nonprogressive radiolucency ranged from 1.8% to 37.3% in the ten zones surrounding the tibial component, and from 0 to 2.2% in the three zones surrounding the talar component. The short-term clinical

  1. 34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Routine checking of hearing aids and external components... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids...

  2. 34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Routine checking of hearing aids and external components... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids...

  3. A Novel Technique for the Connection of Ceramic and Titanium Implant Components Using Glass Solder Bonding

    PubMed Central

    Mick, Enrico; Tinschert, Joachim; Mitrovic, Aurica; Bader, Rainer

    2015-01-01

    Both titanium and ceramic materials provide specific advantages in dental implant technology. However, some problems, like hypersensitivity reactions, corrosion and mechanical failure, have been reported. Therefore, the combining of both materials to take advantage of their pros, while eliminating their respective cons, would be desirable. Hence, we introduced a new technique to bond titanium and ceramic materials by means of a silica-based glass ceramic solder. Cylindrical compound samples (Ø10 mm × 56 mm) made of alumina toughened zirconia (ATZ), as well as titanium grade 5, were bonded by glass solder on their end faces. As a control, a two-component adhesive glue was utilized. The samples were investigated without further treatment, after 30 and 90 days of storage in distilled water at room temperature, and after aging. All samples were subjected to quasi-static four-point-bending tests. We found that the glass solder bonding provided significantly higher bending strength than adhesive glue bonding. In contrast to the glued samples, the bending strength of the soldered samples remained unaltered by the storage and aging treatments. Scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analyses confirmed the presence of a stable solder-ceramic interface. Therefore, the glass solder technique represents a promising method for optimizing dental and orthopedic implant bondings. PMID:28793440

  4. Titanium niobium nitride knee implants are not inferior to chrome cobalt components for primary total knee arthroplasty.

    PubMed

    Thienpont, Emmanuel

    2015-12-01

    Metal allergy in total knee arthroplasty (TKA) is still a controversial topic. Oxinium, ceramic or titanium niobium nitride (TiNbN) coated implants are available for some knee systems. The hypothesis of this study was that the use of TiNbN-coated components would not lead to inferior results compared to conventional implants and that none of the allergic patients receiving TiNbN-coated implants would require revision for metal allergy. This study was a retrospective, 2 to 1 matched pairs study with 40 titanium niobium nitride-coated TKA compared with 80 conventional cobalt chrome implants. No demographic differences between these groups were observed. The mean follow-up for this study was 2 years. No differences in clinical, radiological, or patient-reported outcome measurements were observed between the two groups. No patients have been revised at this short- to medium-term outcome evaluation. Metal allergy leading to contact or systemic dermatitis is especially linked to chrome and cobalt allergy. Nickel allergy because of knee implants rarely gives cutaneous symptoms, but could potentially lead to peri-prosthetic osteolysis and loosening. The use of titanium niobium nitride implants in case of a positive history of metal allergy could avoid this devastating complication. The use of titanium niobium nitride-coated implants for primary knee osteoarthritis shows similar clinical and radiological outcomes as conventional TKA without revision for loosening at short- to medium-term follow-up. Level of evidence Level IV study.

  5. 34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Routine checking of hearing aids and external... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids...

  6. 34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Routine checking of hearing aids and external... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids...

  7. 34 CFR 300.113 - Routine checking of hearing aids and external components of surgically implanted medical devices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Routine checking of hearing aids and external... Eligibility Other Fape Requirements § 300.113 Routine checking of hearing aids and external components of surgically implanted medical devices. (a) Hearing aids. Each public agency must ensure that hearing aids...

  8. A Method of Producing Surface Conduction on Ceramic Accelerator Components Using Metal Ion Implantation

    SciTech Connect

    Liu, F.; Brown, I.; Phillips, H.; Biallas, George; Siggins, Timothy

    1997-05-01

    An important technique used for the suppression of surface flashover on high voltage DC ceramic insulators as well as for RF windows is that of providing some surface conduction to bleed off accumulated surface charge. We have used metal ion implantation to modify the surface of high voltage ceramic vacuum insulators to provide a niform surface resistivity of approximately 5 x 1010 W/square. A vacuum arc ion source based implanter was used to implant Pt at an energy of about 135 keV to doses of up to more than 5 x 1016 ions/cm2 into small ceramic test coupons and also into the inside surface of several ceramic accelerator columns 25 cm I. D. by 28 cm long. Here we describe the experimental set-up used to do the ion implantation and summarize the results of our exploratory work on implantation into test coupons as well as the implantations of the actual ceramic columns.

  9. Development of a multi-component fiber-reinforced composite implant for load-sharing conditions.

    PubMed

    Zhao, D S; Moritz, N; Laurila, P; Mattila, R; Lassila, L V J; Strandberg, N; Mäntylä, T; Vallittu, P K; Aro, H T

    2009-05-01

    Fiber-reinforced composites (FRC) have the potential for use as load-bearing orthopaedic implants if the high strength and elastic modulus of FRC implant can be matched with local requirements. This study tested the in vivo performance of novel FRC implants made of unidirectional glass fibers (E-glass fibers in Bis-GMA and TEGDMA polymeric matrix). The implant surface was covered with bioactive glass granules. Control implants were made of surface-roughened titanium. Stress-shielding effects of the implants were predicted by finite element modelling (FEM). Surgical stabilization of bone metastasis in the subtrochanteric region of the femur was simulated in 12 rabbits. An oblong subtrochanteric defect of a standardized size (reducing the torsional strength of the bones approximately by 66%) was created and an intramedullary implant made of titanium or the FRC composite was inserted. The contralateral femur served as the intact control. At 12 weeks of healing, the femurs were harvested and analyzed by radiography, torsional testing, micro-CT imaging and hard tissue histology. The functional recovery was unremarkable in both groups, although the final analysis revealed two healed undisplaced peri-implant fractures in the group of FRC implants. FEM studies demonstrated differences in stress-shielding effects of the titanium and FRC implants, but the expected biological consequences did not become evident during the follow-up time of the animal study. Biomechanical testing of the retrieved femurs showed no significant differences between the groups. The torsional strength of the fixed bones had returned the level of contralateral intact femurs. Both implants showed ongrowth of intramedullary new bone. No adverse tissue reactions were observed. Based on these favorable results, a large-scale EU-project (NewBone, www.hb.se/ih/polymer/newbone) has been launched for development of orthopaedic FRC implants.

  10. Effects of various anchoring components and loading conditions on primary stability of acetabular revision implant.

    PubMed

    Voigt, Christian; Schaller, Andreas; Klöhn, Carsten; Scholz, Roger

    2016-11-10

    In revision total hip arthroplasty, until today, orthopaedic surgeons are missing evidence-based guidelines on cementless acetabular cup fixation. 5 finite element models were generated featuring the following anchorage strategies: 1 short peg, 1 long peg, 2 long screws, 3 short screws and zero anchoring components for reference. The micromotions at the implant-bone interface were analyzed for 3 different loadcases, "Seated leg-crossing" (joint force 940 N, impingement force 750 N), "Normal gait" (joint force 1820 N), and "Stumbling" (joint force 4520 N). Within the same loadcase, percentages of interface area below 28 µm are nearly identical in all anchorage strategies. The average percentage of interface area below 28 µm is 31% for "Seated leg-crossing", 17% for "Normal gait", and 11% for "Stumbling". Maximal von Mises stresses in "Normal gait", for example, reach 12 MPa in the short peg, 48 MPa in the long peg, 15 MPa in 1 of the 2 long screws, and 85 MPa in 1 of the 3 short screws. Common orthopaedic practice, to use peg or screw fixation alternatively according to bone availability or other clinical aspects, can be confirmed. The short peg may be a good alternative to the long peg with regard to the preservation of bone stock. However, the current study implies that the extent of potential osseointegration depends less on the chosen anchorage strategy but strongly on postoperative loading conditions. Total hip patients should be instructed on adequate postoperative activities.

  11. Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

    PubMed Central

    2011-01-01

    Background It is unclear whether there is a clinical benefit to adding hydroxyapatite (HA) coatings to total knee implants, especially with the tibial component, where failure of the implant more often occurs. A systematic review of the literature was undertaken to identify all prospective randomized trials for determining whether the overall clinical results (as a function of durability, function, and adverse events) favored HA-coated tibial components. Methods A comprehensive literature search was performed for the years 1990 to September 16, 2010. We restricted our search to randomized controlled trials involving participants receiving either an HA-coated tibia or other forms of tibial fixation. The primary outcome measures evaluated were durability, function, and acute adverse events. Results Data from 926 evaluable primary total knee implants in 14 studies were analyzed. Using an RSA definition for durability, HA-coated tibial components (porous or press-fit) without screw fixation were less likely to be unstable at 2 years than porous and cemented metal-backed tibial components (RR = 0.58, 95% CI: 0.34–0.98; p = 0.04, I2 = 39%, M-H random effects model). There was no significant difference in durability, as measured from revision and evaluated at 2 and 8–10 years, between groups. Also, functional status using different validated measures showed no significant difference at 2 and 5 years, no matter what measure was used. Lastly, there was no significant difference in adverse events. Limitations included small numbers of evaluable patients (≤ 50) in 7 of the 14 trials identified, and a lack of “hard” evidence of durability with need for replacement (i.e. frank failure, pain, or loss of functionality). Interpretation In patients > 65 years of age, an HA-coated tibial implant may provide better durability than other forms of tibial fixation. Larger trials should be undertaken comparing the long-term durability, function, and adverse events of HA

  12. Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty.

    PubMed

    Voigt, Jeffrey D; Mosier, Michael

    2011-08-01

    It is unclear whether there is a clinical benefit to adding hydroxyapatite (HA) coatings to total knee implants, especially with the tibial component, where failure of the implant more often occurs. A systematic review of the literature was undertaken to identify all prospective randomized trials for determining whether the overall clinical results (as a function of durability, function, and adverse events) favored HA-coated tibial components. A comprehensive literature search was performed for the years 1990 to September 16, 2010. We restricted our search to randomized controlled trials involving participants receiving either an HA-coated tibia or other forms of tibial fixation. The primary outcome measures evaluated were durability, function, and acute adverse events. Data from 926 evaluable primary total knee implants in 14 studies were analyzed. Using an RSA definition for durability, HA-coated tibial components (porous or press-fit) without screw fixation were less likely to be unstable at 2 years than porous and cemented metal-backed tibial components (RR = 0.58, 95% CI: 0.34-0.98; p = 0.04, I(2) = 39%, M-H random effects model). There was no significant difference in durability, as measured from revision and evaluated at 2 and 8-10 years, between groups. Also, functional status using different validated measures showed no significant difference at 2 and 5 years, no matter what measure was used. Lastly, there was no significant difference in adverse events. Limitations included small numbers of evaluable patients (≤ 50) in 7 of the 14 trials identified, and a lack of "hard" evidence of durability with need for replacement (i.e. frank failure, pain, or loss of functionality). In patients > 65 years of age, an HA-coated tibial implant may provide better durability than other forms of tibial fixation. Larger trials should be undertaken comparing the long-term durability, function, and adverse events of HA-coated implants with those of other porous

  13. Cast-to-shape electrokinetic trapping medium

    DOEpatents

    Shepodd, Timothy J.; Franklin, Elizabeth; Prickett, Zane T.; Artau, Alexander

    2004-08-03

    A three-dimensional microporous polymer network material, or monolith, cast-to-shape in a microchannel. The polymer monolith, produced by a phase separation process, is capable of trapping and retaining charged protein species from a mixture of charged and uncharged species under the influence of an applied electric field. The retained charged protein species are released from the porous polymer monolith by a pressure driven flow in the substantial absence of the electric field. The pressure driven flow is independent of direction and thus neither means to reverse fluid flow nor a multi-directional flow field is required, a single flow through the porous polymer monolith can be employed, in contrast to prior art systems. The monolithic polymer material produced by the invention can function as a chromatographic medium. Moreover, by virtue of its ability to retain charged protein species and quantitatively release the retained species the porous polymer monolith can serve as a means for concentrating charged protein species from, for example, a dilute solution.

  14. Cast-to-shape electrokinetic trapping medium

    DOEpatents

    Shepodd, Timothy J.; Franklin, Elizabeth; Prickett, Zane T.; Artau, Alexander

    2006-05-30

    A three-dimensional microporous polymer network material, or monolith, cast-to-shape in a microchannel. The polymer monolith, produced by a phase separation process, is capable of trapping and retaining charged protein species from a mixture of charged and uncharged species under the influence of an applied electric field. The retained charged protein species are released from the porous polymer monolith by a pressure driven flow in the substantial absence of the electric field. The pressure driven flow is independent of direction and thus neither means to reverse fluid flow nor a multi-directional flow field is required, a single flow through the porous polymer monolith can be employed, in contrast to prior art systems. The monolithic polymer material produced by the invention can function as a chromatographic medium. Moreover, by virtue of its ability to retain charged protein species and quantitatively release the retained species the porous polymer monolith can serve as a means for concentrating charged protein species from, for example, a dilute solution.

  15. BMM SHAKEOUT AND VIBRATING CONVEYOR TRANSPORT SAND AND CASTINGS TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    BMM SHAKEOUT AND VIBRATING CONVEYOR TRANSPORT SAND AND CASTINGS TO SEPARATIONS SCREENS. - Southern Ductile Casting Company, Shaking, Degating & Sand Systems, 2217 Carolina Avenue, Bessemer, Jefferson County, AL

  16. Histologic studies on osseointegration: soft tissues response to implant surfaces and components. A review.

    PubMed

    Piattelli, Adriano; Pontes, Ana Emilia Farias; Degidi, Marco; Iezzi, Giovanna

    2011-01-01

    It is important to clarify the potential response of different types of cells to different implant materials and topographies. Thus, in vitro studies are performed using cell cultures, in order to evaluate, among other characteristics, the morphology, orientation, proliferation and adhesion of the cells. Histology evaluation are performed in animals or humans to describe the physiological response to different surfaces.

  17. Custom-designed orthopedic implants evaluated using finite element analysis of patient-specific computed tomography data: femoral-component case study

    PubMed Central

    Harrysson, Ola LA; Hosni, Yasser A; Nayfeh, Jamal F

    2007-01-01

    Background Conventional knee and hip implant systems have been in use for many years with good success. However, the custom design of implant components based on patient-specific anatomy has been attempted to overcome existing shortcomings of current designs. The longevity of cementless implant components is highly dependent on the initial fit between the bone surface and the implant. The bone-implant interface design has historically been limited by the surgical tools and cutting guides available; and the cost of fabricating custom-designed implant components has been prohibitive. Methods This paper describes an approach where the custom design is based on a Computed Tomography scan of the patient's joint. The proposed design will customize both the articulating surface and the bone-implant interface to address the most common problems found with conventional knee-implant components. Finite Element Analysis is used to evaluate and compare the proposed design of a custom femoral component with a conventional design. Results The proposed design shows a more even stress distribution on the bone-implant interface surface, which will reduce the uneven bone remodeling that can lead to premature loosening. Conclusion The proposed custom femoral component design has the following advantages compared with a conventional femoral component. (i) Since the articulating surface closely mimics the shape of the distal femur, there is no need for resurfacing of the patella or gait change. (ii) Owing to the resulting stress distribution, bone remodeling is even and the risk of premature loosening might be reduced. (iii) Because the bone-implant interface can accommodate anatomical abnormalities at the distal femur, the need for surgical interventions and fitting of filler components is reduced. (iv) Given that the bone-implant interface is customized, about 40% less bone must be removed. The primary disadvantages are the time and cost required for the design and the possible need

  18. Custom-designed orthopedic implants evaluated using finite element analysis of patient-specific computed tomography data: femoral-component case study.

    PubMed

    Harrysson, Ola L A; Hosni, Yasser A; Nayfeh, Jamal F

    2007-09-13

    Conventional knee and hip implant systems have been in use for many years with good success. However, the custom design of implant components based on patient-specific anatomy has been attempted to overcome existing shortcomings of current designs. The longevity of cementless implant components is highly dependent on the initial fit between the bone surface and the implant. The bone-implant interface design has historically been limited by the surgical tools and cutting guides available; and the cost of fabricating custom-designed implant components has been prohibitive. This paper describes an approach where the custom design is based on a Computed Tomography scan of the patient's joint. The proposed design will customize both the articulating surface and the bone-implant interface to address the most common problems found with conventional knee-implant components. Finite Element Analysis is used to evaluate and compare the proposed design of a custom femoral component with a conventional design. The proposed design shows a more even stress distribution on the bone-implant interface surface, which will reduce the uneven bone remodeling that can lead to premature loosening. The proposed custom femoral component design has the following advantages compared with a conventional femoral component. (i) Since the articulating surface closely mimics the shape of the distal femur, there is no need for resurfacing of the patella or gait change. (ii) Owing to the resulting stress distribution, bone remodeling is even and the risk of premature loosening might be reduced. (iii) Because the bone-implant interface can accommodate anatomical abnormalities at the distal femur, the need for surgical interventions and fitting of filler components is reduced. (iv) Given that the bone-implant interface is customized, about 40% less bone must be removed. The primary disadvantages are the time and cost required for the design and the possible need for a surgical robot to perform the

  19. Hydroxyapatite nanocrystals functionalized with alendronate as bioactive components for bone implant coatings to decrease osteoclastic activity

    NASA Astrophysics Data System (ADS)

    Bosco, Ruggero; Iafisco, Michele; Tampieri, Anna; Jansen, John A.; Leeuwenburgh, Sander C. G.; van den Beucken, Jeroen J. J. P.

    2015-02-01

    The integration of bone implants within native bone tissue depends on periprosthetic bone quality, which is severely decreased in osteoporotic patients. In this work, we have synthesized bone-like hydroxyapatite nanocrystals (nHA) using an acid-base neutralization reaction and analysed their physicochemical properties. Subsequently, we have functionalized the nHA with alendronate (nHAALE), a well-known bisphosphonate drug used for the treatment of osteoporosis. An in vitro osteoclastogenesis test was carried out to evaluate the effect of nHAALE on the formation of osteoclast-like cells from monocytic precursor cells (i.e. RAW264.7 cell line) showing that nHAALE significantly promoted apoptosis of osteoclast-like cells. Subsequently, nHA and nHAALE were deposited on titanium disks using electrospray deposition (ESD), for which characterisation of the deposited coatings confirmed the presence of alendronate in nHAALE coatings with nanoscale thickness of about 700 nm. These results indicate that alendronate linked to hydroxyapatite nanocrystals has therapeutic potential and nHAALE can be considered as an appealing coating constituent material for orthopaedic and oral implants for application in osteoporotic patients.

  20. [Simulation of speech perception with cochlear implants : Influence of frequency and level of fundamental frequency components with electronic acoustic stimulation].

    PubMed

    Rader, T; Fastl, H; Baumann, U

    2017-03-01

    After implantation of cochlear implants with hearing preservation for combined electronic acoustic stimulation (EAS), the residual acoustic hearing ability relays fundamental speech frequency information in the low frequency range. With the help of acoustic simulation of EAS hearing perception the impact of frequency and level fine structure of speech signals can be systematically examined. The aim of this study was to measure the speech reception threshold (SRT) under various noise conditions with acoustic EAS simulation by variation of the frequency and level information of the fundamental frequency f0 of speech. The study was carried out to determine to what extent the SRT is impaired by modification of the f0 fine structure. Using partial tone time pattern analysis an acoustic EAS simulation of the speech material from the Oldenburg sentence test (OLSA) was generated. In addition, determination of the f0 curve of the speech material was conducted. Subsequently, either the parameter frequency or level of f0 was fixed in order to remove one of the two fine contour information of the speech signal. The processed OLSA sentences were used to determine the SRT in background noise under various test conditions. The conditions "f0 fixed frequency" and "f0 fixed level" were tested under two different situations, under "amplitude modulated background noise" and "continuous background noise" conditions. A total of 24 subjects with normal hearing participated in the study. The SRT in background noise for the condition "f0 fixed frequency" was more favorable in continuous noise with 2.7 dB and in modulated noise with 0.8 dB compared to the condition "f0 fixed level" with 3.7 dB and 2.9 dB, respectively. In the simulation of speech perception with cochlear implants and acoustic components, the level information of the fundamental frequency had a stronger impact on speech intelligibility than the frequency information. The method of simulation of transmission of

  1. Package architecture and component design for an implanted neural stimulator with closed loop control.

    PubMed

    Bjune, Caroline K; Marinis, Thomas F; Brady, Jeanne M; Moran, James; Wheeler, Jesse; Sriram, Tirunelveli S; Parks, Philip D; Widge, Alik S; Dougherty, Darin D; Eskandar, Emad N

    2015-08-01

    An implanted neural stimulator with closed loop control requires electrodes for stimulation pulses and recording neuron activity. Our system features arrays of 64 electrodes. Each electrode can be addressed through a cross bar switch, to enable it to be used for stimulation or recording. This electrode switch, a bank of low noise amplifiers with an integrated analog to digital converter, power conditioning electronics, and a communications and control gate array are co-located with the electrode array in a 14 millimeter diameter satellite package that is designed to be flush mounted in a skull burr hole. Our system features five satellite packages connected to a central hub processor-controller via ten conductor cables that terminate in a custom designed, miniaturized connector. The connector incorporates features of high reliability, military grade devices and utilizes three distinct seals to isolate the contacts from fluid permeation. The hub system is comprised of a connector header, hermetic electronics package, and rechargeable battery pack, which are mounted on and electrically interconnected by a flexible circuit board. The assembly is over molded with a compliant silicone rubber. The electronics package contains two antennas, a large coil, used for recharging the battery and a high bandwidth antenna that is used to download data and update software. The package is assembled from two machined alumina pieces, a flat base with brazed in, electrical feed through pins and a rectangular cover with rounded corners. Titanium seal rings are brazed onto these two pieces so that they can be sealed by laser welding. A third system antenna is incorporated in the flexible circuit board. It is used to communicate with an externally worn control package, which monitors the health of the system and allows both the user and clinician to control or modify various system function parameters.

  2. The protective effect of pulsed lavage against implant subsidence and micromotion for cemented tibial unicompartmental knee components: an experimental cadaver study.

    PubMed

    Jaeger, Sebastian; Rieger, Johannes S; Bruckner, Thomas; Kretzer, J Philippe; Clarius, Michael; Bitsch, Rudi G

    2014-04-01

    Cemented UKAs were performed in 12 pairs of human cadaver legs and the bone bed was cleansed using pulsed lavage (group A) and conventional syringe lavage (group B). Subsidence and micromotion of the loaded tibial trays were measured. There was a significant effect of BMD on subsidence (P = 0.043) but not on micromotion. Cement penetration of group A was significantly increased (P = 0.005). Group A showed a reduced implant subsidence (P = 0.025) and micromotion (P = 0.026) compared to group B. The group differences in micromotion and implant subsidence of UKA tibial components were statistically significant but rather small and might clinically be of minor importance. Nevertheless a worse bone quality adversely affected implant subsidence and pulsed lavage had a protective effect in these specimens.

  3. Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types.

    PubMed

    Meisberger, Eric W; Bakker, Sjoerd J G; Cune, Marco S

    2015-12-01

    Ultrasonic instrumentation under magnification may facilitate mobilization of screw remnants but may induce heat trauma to surrounding bone. An increase of 5°C is considered detrimental to osseointegration. The objective of this investigation was to examine the rise in temperature of the outer implant body after 30 s of ultrasonic instrumentation to the inner part, in relation to implant type, type of ultrasonic equipment, and the use of coolants in vitro. Two ultrasonic devices (Satelec Suprasson T Max and Electro Medical Systems (EMS) miniMaster) were used on five different implant types that were provided with a thermo couple (Astra 3.5 mm, bone level Regular CrossFit (RC) 4.1 mm, bone level Narrow CrossFit (NC) 3.3 mm, Straumann tissue level regular body regular neck 3.3 mm, and Straumann tissue level wide body regular neck 4.8 mm), either with or without cooling during 30 s. Temperature rise at this point in time is the primary outcome measure. In addition, the mean maximum rise in temperature (all implants combined) was assessed and statistically compared among devices, implant systems, and cooling mode (independent t-tests, ANOVA, and post hoc analysis). The Satelec device without cooling induces the highest temperature change of up to 13°C, particularly in both bone level implants (p < 0.05) but appears safe for approximately 10 s of continuous instrumentation, after which a cooling down period is rational. Cooling is effective for both devices. However, when the Satelec device is used with coolant for a longer period of time, a rise in temperature must be anticipated after cessation of instrumentation, and post-operational cooling is advised. The in vitro setup used in this experiment implies that care should be taken when translating the observations to clinical recommendations, but it is carefully suggested that the EMS device causes limited rise in temperature, even without coolant.

  4. Analysis of severely fractured glenoid components: clinical consequences of biomechanics, design, and materials selection on implant performance.

    PubMed

    Ansari, Farzana; Lee, Taylor; Malito, Louis; Martin, Audrey; Gunther, Stephen B; Harmsen, Samuel; Norris, Tom R; Ries, Mike; Van Citters, Douglas; Pruitt, Lisa

    2016-07-01

    The longevity of total shoulder replacement is primarily limited by the performance of the ultrahigh-molecular-weight polyethylene (UHMWPE) glenoid component in vivo. Variations in glenoid design (conformity, thickness), biomechanics (joint kinematics), and UHMWPE material selection (sterilization, cross-linking) distinguish total shoulder replacements from hip and knee arthroplasty devices. These variables can lead to severe mechanical failures, including gross fracture. Sixteen retrieved glenoids with severe fracture were analyzed. The explant cohort included 3 material groups (gamma-sterilized Hylamer; gamma-sterilized UHMWPE; and gas plasma-sterilized, remelted, highly cross-linked UHMWPE [HXL]) and a range of conformities (0- to 10-mm radial mismatch). Analysis included fractography (optical and scanning electron microscopy) and Fourier transform infrared spectroscopy for oxidative analysis. Fracture primarily occurred along the exterior rim for all 16 explants. Fourier transform infrared analysis and fractography revealed significant oxidative embrittlement for all gamma-sterilized glenoids. Fatigue striations and internal flaws were evident on the fracture surface of the HXL glenoid, with little oxidation detected. Fracture initiated at the external rim of all devices. Elevated oxidation levels and visible material distortion for representative gamma-sterilized conventional and Hylamer devices suggest oxidative embrittlement as a driving force for crack inception and subsequent fracture. Brittle fracture of theHXL glenoid resulted from a combination of elevated contact stress due to a nonconforming surface, an internal flaw, and reduced resistance to fatigue crack growth. This demonstrates that glenoid fracture associated with oxidation has not been eliminated with the advent of modern materials (HXL) in the shoulder domain. Basic Science Study; Implant Retrieval Study. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by

  5. A method of producing very high resistivity surface conduction on ceramic accelerator components using metal ion implantation

    SciTech Connect

    F. Liu; I. Brown; L. Phillips; G. Biallas; T. Siggins

    1997-05-01

    An important technique used for the suppression of surface flashover on high voltage DC ceramic insulators as well as for RF windows is that of providing some surface conduction to bleed off accumulated surface charge. The authors have used metal ion implantation to modify the surface of high voltage ceramic vacuum insulators to provide a uniform surface resistivity of approximately 5 x 10{sup 10} Q{sup 2}. A vacuum arc ion source based implanter was used to implant Pt at an energy of about 135 MeV to doses of up to more than 5 x 10{sup 16} ions cm{sup 2} into small ceramic test coupons and also into the inside surface of several ceramic accelerator columns 25 cm I. D. by 28 cm long. Here they describe the experimental set-up used to do the ion implantation and summarize the results of their exploratory work on implantation into test coupons as well as the implantations of the actual ceramic columns.

  6. Effect of increased crown height on stress distribution in short dental implant components and their surrounding bone: A finite element analysis.

    PubMed

    Bulaqi, Haddad Arabi; Mousavi Mashhadi, Mahmoud; Safari, Hamed; Samandari, Mohammad Mahdi; Geramipanah, Farideh

    2015-06-01

    Implants in posterior regions of the jaw require short dental implants with long crown heights, leading to increased crown-to-implant ratios and mechanical stress. This can lead to fracture and screw loosening. The purpose of this study was to investigate the dynamic nature and behavior of prosthetic components and preimplant bone and evaluate the effect of increased crown height space (CHS) and crown-to-implant ratio on stress concentrations under external oblique forces. The severely resorbed bone of a posterior mandible site was modeled with Mimics and Catia software. A second mandibular premolar tooth was modeled with CHS values of 8.8, 11.2, 13.6, and 16 mm. A Straumann implant (4.1×8 mm), a directly attached crown, and an abutment screw were modeled with geometric data and designed by using SolidWorks software. Abaqus software was used for the dynamic simulation of screw tightening and the application of an external load to the buccal cusp at a 75.8-degree angle with the occlusal plane. The distribution of screw load and member load at each step was compared, and the stress values were calculated within the dental implant complex and surrounding bone. During tightening, the magnitude and distribution of the preload and clamp load were uniform and equal at the cross section of all CHSs. Under an external load, the screw load decreased and member load increased. An increase in the CHS caused the corresponding distribution to become more nonuniform and increased the maximum compressive and tensile stresses in the preimplant bone. Additionally, the von Mises stress decreased at the abutment screw and increased at the abutment and fixture. Under nonaxial forces, increased CHS does not influence the decrease in screw load or increase in member load. However, it contributes to screw loosening and fatigue fracture by skewing the stress distribution to the transverse section of the implant. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry

  7. Inflammasome components ASC and AIM2 modulate the acute phase of biomaterial implant-induced foreign body responses

    PubMed Central

    Christo, Susan N.; Diener, Kerrilyn R.; Manavis, Jim; Grimbaldeston, Michele A.; Bachhuka, Akash; Vasilev, Krasimir; Hayball, John D.

    2016-01-01

    Detailing the inflammatory mechanisms of biomaterial-implant induced foreign body responses (FBR) has implications for revealing targetable pathways that may reduce leukocyte activation and fibrotic encapsulation of the implant. We have adapted a model of poly(methylmethacrylate) (PMMA) bead injection to perform an assessment of the mechanistic role of the ASC-dependent inflammasome in this process. We first demonstrate that ASC−/− mice subjected to PMMA bead injections had reduced cell infiltration and altered collagen deposition, suggesting a role for the inflammasome in the FBR. We next investigated the NLRP3 and AIM2 sensors because of their known contributions in recognising damaged and apoptotic cells. We found that NLRP3 was dispensable for the fibrotic encapsulation; however AIM2 expression influenced leukocyte infiltration and controlled collagen deposition, suggesting a previously unexplored link between AIM2 and biomaterial-induced FBR. PMID:26860464

  8. Inflammasome components ASC and AIM2 modulate the acute phase of biomaterial implant-induced foreign body responses.

    PubMed

    Christo, Susan N; Diener, Kerrilyn R; Manavis, Jim; Grimbaldeston, Michele A; Bachhuka, Akash; Vasilev, Krasimir; Hayball, John D

    2016-02-10

    Detailing the inflammatory mechanisms of biomaterial-implant induced foreign body responses (FBR) has implications for revealing targetable pathways that may reduce leukocyte activation and fibrotic encapsulation of the implant. We have adapted a model of poly(methylmethacrylate) (PMMA) bead injection to perform an assessment of the mechanistic role of the ASC-dependent inflammasome in this process. We first demonstrate that ASC(-/-) mice subjected to PMMA bead injections had reduced cell infiltration and altered collagen deposition, suggesting a role for the inflammasome in the FBR. We next investigated the NLRP3 and AIM2 sensors because of their known contributions in recognising damaged and apoptotic cells. We found that NLRP3 was dispensable for the fibrotic encapsulation; however AIM2 expression influenced leukocyte infiltration and controlled collagen deposition, suggesting a previously unexplored link between AIM2 and biomaterial-induced FBR.

  9. Global protein expression analysis of molecular markers of DS-1-47, a component of implantation-promoting traditional chinese medicine.

    PubMed

    Li, Yan-Ling; Zhang, Xiao-Yan; Leng, Yu; Wu, Yan-Li; Li, Jing; Wu, Yun-Xia

    2016-12-01

    This study investigated the molecular markers of DS-1-47, a component of an implantation- promoting traditional Chinese medicine consisting of Astragalus mongholicus, Atractylodes macrocephala, Scutellaria baicalensis and Dipsacales, in an attempt to clarify the molecular mechanism and action targets of DS-1-47. Controlled ovarian stimulation (COS) method was used to establish the implantation dysfunction models of mice. Animals were divided into normal pregnant group, COS model group and DS-1-47 group. Laser capture microdissection-double dimensional electrophoresis-mass spectrum (LCM-DE-MS) was used to analyze the uterine protein molecules that were possibly involved in the promotion of implantation. Twenty-three proteins in DS-1-47 group were significantly changed as compared to those in COS model group, with 7 proteins down-regulated and 16 proteins up-regulated. Except for some constituent proteins, the down-regulated proteins included collagen α-1 (VI) chain, keratin 7, keratin 14, myosin regulatory light chain 12B, myosin light polypeptide 9, heat shock protein β-7, and C-U-editing enzyme APOBEC-2; the up-regulated proteins included apolipoprotein A-I, calcium regulated protein-3, proliferating cell nuclear antigen, L-xylulose reductase, and calcium binding protein. These 23 proteins that were regulated by DS-1-47 represented a broad diversity of molecule functions. The down-regulated proteins were associated with stress and immune response, and those up-regulated proteins were related to proliferation. It was suggested that these proteins were important in regulating the uterine environment for the blastocyst implantation. By identification of DS-1-47 markers, proteomic analysis coupled with functional assays is demonstrated to be a promising approach to better understand the molecular mechanism of traditional Chinese medicine.

  10. The stability of dual-taper modular hip implants: a biomechanical analysis examining the effect of impact location on component stability.

    PubMed

    Frisch, Nicholas B; Lynch, Jonathan R; Banglmaier, Richard F; Silverton, Craig D

    2017-06-01

    The purpose of this study was to investigate the stability of dual-taper modular implants following impaction forces delivered at varying locations as measured by the distraction forces required to disassemble the components. Distraction of the head-neck and neck-stem (NS) tapers of dual-taper modular implants with 0°, 8°, and 15° neck angles were measured utilizing a custom-made distraction fixture attached to a servohydraulic materials test machine. Distraction was measured after hand pressing the components as well as following a simulated firm hammer blow impaction. Impacts to the 0°, 8°, 15° necks were directed axially in line with the neck, 10° anterior, and 10° proximal to the axis of the neck, respectively. Impaction increased the range of NS component distraction forces when compared to hand pressed components (1125-1743 N vs 248-302 N, respectively). Off-axis impacts resulted in significantly reduced mean (±95% confidence interval) distraction forces (8° neck, 1125 ± 117 N; 15° neck, 1212 ± 73 N), which were up to 35% lower than the mean distraction force for axial impacts to the 0° neck (1743 ± 138 N). Direction of impaction influences stability of the modular interface. The greatest stability was achieved with impaction directed in line with the longitudinal axis of the taper junction. Off-axis impaction of the 8° and 15° neck led to significantly reduced stability at the NS. Improving stability of dual-taper modular hip prostheses with appropriately directed impaction may help to minimize micromotion, component settling, fretting corrosion, and subsequent failure.

  11. Use of aluminum strips to fabricate verification jig for an implant-supported fixed partial denture.

    PubMed

    Papazian, S; Morgano, S M

    1998-03-01

    Verification of the accuracy of the master cast for an implant-supported fixed partial denture will reduce the chair time and laboratory costs of implant prosthodontic treatment. A wire is usually luted in the mouth to machined components that have been secured to the implants, and the luted assembly is then transferred to the cast to evaluate the positional accuracy of the implant analogs. Unless this wire is dead soft, inaccuracies as a result of elastic memory of the wire can occur. Also, if the wire is not completely rigid, it can be distorted during handling. This article describes a more reliable verification jig for an implant-supported fixed partial denture that can be fabricated with 1.5 mm thick aluminum strips that are luted to the implant components. The use of two aluminum strips creates a metal framework that is rigid and not easily distorted. Also the aluminum pieces do not have elastic memory because they were cut and not bent to shape.

  12. Aqueous Extract of Brazilian Green Propolis: Primary Components, Evaluation of Inflammation and Wound Healing by Using Subcutaneous Implanted Sponges

    PubMed Central

    de Moura, Sandra Aparecida Lima; Negri, Giuseppina; Salatino, Antônio; Lima, Luiza Dias da Cunha; Dourado, Luana Pereira Antunes; Mendes, Juliana Barros; Andrade, Silvia Passos; Ferreira, Mônica Alves Neves Diniz; Cara, Denise Carmona

    2011-01-01

    Propolis is a chemically complex resinous bee product which has gained worldwide popularity as a means to improve health condition and prevent diseases. The main constituents of an aqueous extract of a sample of green propolis from Southeast Brazil were shown by high performance liquid chromatography/mass spectroscopy/mass spectroscopy to be mono- and di-O-caffeoylquinic acids; phenylpropanoids known as important constituents of alcohol extracts of green propolis, such as artepillin C and drupanin were also detected in low amounts in the aqueous extract. The anti-inflammatory activity of this extract was evaluated by determination of wound healing parameters. Female Swiss mice were implanted subcutaneously with polyesther-polyurethane sponge discs to induce wound healing responses, and administered orally with green propolis (500 mg kg−1). At 4, 7 and 14 days post-implantation, the fibrovascular stroma and deposition of extracellular matrix were evaluated by histopathologic and morphometric analyses. In the propolis-treated group at Days 4 and 7 the inflammatory process in the sponge was reduced in comparison with control. A progressive increase in cell influx and collagen deposition was observed in control and propolis-treated groups during the whole period. However, these effects were attenuated in the propolis-treated group at Days 4 and 7, indicating that key factors of the wound healing process are modulated by propolis constituents. PMID:19690045

  13. Effect of Blood Component Coatings of Enosseal Implants on Proliferation and Synthetic Activity of Human Osteoblasts and Cytokine Production of Peripheral Blood Mononuclear Cells.

    PubMed

    Himmlova, Lucie; Kubies, Dana; Hulejova, Hana; Bartova, Jirina; Riedel, Tomas; Stikarova, Jana; Suttnar, Jiri; Pesakova, Vlasta

    2016-01-01

    The study monitored in vitro early response of connective tissue cells and immunocompetent cells to enosseal implant materials coated by different blood components (serum, activated plasma, and plasma/platelets) to evaluate human osteoblast proliferation and synthetic activity and inflammatory response presented as a cytokine profile of peripheral blood mononuclear cells (PBMCs) under conditions imitating the situation upon implantation. The cells were cultivated on coated Ti-plasma-sprayed (Ti-PS), Ti-etched (Ti-Etch), Ti-hydroxyapatite (Ti-HA), and ZrO2 surfaces. The plasma/platelets coating supported osteoblast proliferation only on osteoconductive Ti-HA and Ti-Etch whereas activated plasma enhanced proliferation on all surfaces. Differentiation (BAP) and IL-8 production remained unchanged or decreased irrespective of the coating and surface; only the serum and plasma/platelets-coated ZrO2 exhibited higher BAP and IL-8 expression. RANKL production increased on serum and activated plasma coatings. PBMCs produced especially cytokines playing role in inflammatory phase of wound healing, that is, IL-6, GRO-α, GRO, ENA-78, IL-8, GM-CSF, EGF, and MCP-1. Cytokine profiles were comparable for all tested surfaces; only ENA-78, IL-8, GM-CSF, and MCP-1 expression depended on materials and coatings. The activated plasma coating led to uniformed surfaces and represented a favorable treatment especially for bioinert Ti-PS and ZrO2 whereas all coatings had no distinctive effect on bioactive Ti-HA and Ti-Etch.

  14. Surface Protection and Improved Performance of Satellite Components as well as Mitigation of Space Environmental Pollution by Plasma Ion Implantation

    NASA Astrophysics Data System (ADS)

    Ueda, M.; Takahashi, W. K.; Marcondes, A. R.; Tan, I. H.; Silva, G.

    2009-01-01

    Three plasma processing systems based on PII technique have been used in the improvement of surface properties of different materials important for aerospace and space applications. Metal plasma PII of Al and Mg was used for surface protection of polymers used in space such as Kapton, Mylar and polyethylene. Al alloys were treated with nitrogen PII for improved resistance to corrosion aiming at aerospace applications. A rigid polymer UHMWPE was also treated in a nitrogen PII to produce a protective layer with DLC. Although not very light, SS304 stainless steel components are being used in a imaging camera in space, and some components made of this material showed endurance to vibration tests after nitrogen PII, therefore being qualified for on-board application.

  15. Surface Protection and Improved Performance of Satellite Components as well as Mitigation of Space Environmental Pollution by Plasma Ion Implantation

    SciTech Connect

    Ueda, M.; Takahashi, W. K.; Marcondes, A. R.; Tan, I. H.; Silva, G.

    2009-01-05

    Three plasma processing systems based on PII technique have been used in the improvement of surface properties of different materials important for aerospace and space applications. Metal plasma PII of Al and Mg was used for surface protection of polymers used in space such as Kapton, Mylar and polyethylene. Al alloys were treated with nitrogen PII for improved resistance to corrosion aiming at aerospace applications. A rigid polymer UHMWPE was also treated in a nitrogen PII to produce a protective layer with DLC. Although not very light, SS304 stainless steel components are being used in a imaging camera in space, and some components made of this material showed endurance to vibration tests after nitrogen PII, therefore being qualified for on-board application.

  16. [Biomaterials in cochlear implants].

    PubMed

    Stöver, T; Lenarz, T

    2009-05-01

    Cochlear implants (CI) represent the "gold standard" for the treatment of congenitally deaf children and postlingually deafened adults. Thus, cochlear implantation is a success story of new bionic prosthesis development. Owing to routine application of cochlear implants in adults but also in very young children (below the age of one), high demands are placed on the implants. This is especially true for biocompatibility aspects of surface materials of implant parts which are in contact with the human body. In addition, there are various mechanical requirements which certain components of the implants must fulfil, such as flexibility of the electrode array and mechanical resistance of the implant housing. Due to the close contact of the implant to the middle ear mucosa and because the electrode array is positioned in the perilymphatic space via cochleostomy, there is a potential risk of bacterial transferral along the electrode array into the cochlea. Various requirements that have to be fulfilled by cochlear implants, such as biocompatibility, electrode micromechanics, and although a very high level of technical standards has been carried out there is still demand for the improvement of implants as well as of the materials used for manufacturing, ultimately leading to increased implant performance. General considerations of material aspects related to cochlear implants as well as potential future perspectives of implant development will be discussed.

  17. Effect of Blood Component Coatings of Enosseal Implants on Proliferation and Synthetic Activity of Human Osteoblasts and Cytokine Production of Peripheral Blood Mononuclear Cells

    PubMed Central

    Hulejova, Hana; Bartova, Jirina; Riedel, Tomas; Pesakova, Vlasta

    2016-01-01

    The study monitored in vitro early response of connective tissue cells and immunocompetent cells to enosseal implant materials coated by different blood components (serum, activated plasma, and plasma/platelets) to evaluate human osteoblast proliferation and synthetic activity and inflammatory response presented as a cytokine profile of peripheral blood mononuclear cells (PBMCs) under conditions imitating the situation upon implantation. The cells were cultivated on coated Ti-plasma-sprayed (Ti-PS), Ti-etched (Ti-Etch), Ti-hydroxyapatite (Ti-HA), and ZrO2 surfaces. The plasma/platelets coating supported osteoblast proliferation only on osteoconductive Ti-HA and Ti-Etch whereas activated plasma enhanced proliferation on all surfaces. Differentiation (BAP) and IL-8 production remained unchanged or decreased irrespective of the coating and surface; only the serum and plasma/platelets-coated ZrO2 exhibited higher BAP and IL-8 expression. RANKL production increased on serum and activated plasma coatings. PBMCs produced especially cytokines playing role in inflammatory phase of wound healing, that is, IL-6, GRO-α, GRO, ENA-78, IL-8, GM-CSF, EGF, and MCP-1. Cytokine profiles were comparable for all tested surfaces; only ENA-78, IL-8, GM-CSF, and MCP-1 expression depended on materials and coatings. The activated plasma coating led to uniformed surfaces and represented a favorable treatment especially for bioinert Ti-PS and ZrO2 whereas all coatings had no distinctive effect on bioactive Ti-HA and Ti-Etch. PMID:27651560

  18. Cochlear Implants

    MedlinePlus

    ... Medical Procedures Implants and Prosthetics Cochlear Implants Cochlear Implants Share Tweet Linkedin Pin it More sharing options ... normal ear, ear with hearing loss, and cochlear implant procedure Welcome to the Food and Drug Administration ( ...

  19. Ultra Large Castings to Produce Low Cost Aluminum Vehicle Structures

    SciTech Connect

    T. N. Meyer; M. J. Kinosz; E. M. Bradac; M. Mbaye; J. T. Burg; M. A. Klingensmith

    1999-04-26

    Through a cooperative effort with the U.S. Department of Energy (DOE) Office of Heavy Vehicle Technologies (OHVT), Alcoa is developing a casting process to produce ultra large thin wall components. The casting process is a low pressure, metal mold, multiport injection vertical casting process. The specific system for demonstration of the process is located at Alcoa's Technology Center and will be capable of producing parts extending 3 M long, 1.7 M wide and 0.4 M high. For example, single castings of car floor pan frames or side wall aperture structures are candidates for this installation. This shall provide a major opportunity to reduce the cost of lightweight transportation vehicle structures by (a) reducing the components or part count and (b) reducing the cost of assembly. To develop and demonstrate the process, an inner panel of the Chrysler minivan liftgate will be first produced on this system. Through computer analyses, the cast inner panel design was developed to satisfy both structural performance and casting process requirements. Currently, this is an 11 part assembly of steel components. At the time of this abstract, the numerous system components are in various phases of fabrication and site preparation is fully underway, with system shakedown beginning in the second quarter of 1999. Successful demonstration of caster system operation is anticipated to occur during the third quarter and production of a high quality product during the fourth quarter. Although the process is targeted toward reducing the cost of lightweight trucks, buses and autos, consideration is being given to application in the aircraft industry.

  20. Cemented all-polyethylene and metal-backed polyethylene tibial components used for primary total knee arthroplasty: a systematic review of the literature and meta-analysis of randomized controlled trials involving 1798 primary total knee implants.

    PubMed

    Voigt, Jeffrey; Mosier, Michael

    2011-10-05

    The cost of the implant as part of a total knee arthroplasty accounts for a substantial portion of the costs for the overall procedure: all-polyethylene tibial components cost considerably less than cemented metal-backed tibial components. We performed a systematic review of the literature to determine whether the clinical results of lower-cost all-polyethylene tibial components were comparable with the results of a more expensive metal-backed tibial component. We searched The Cochrane Library, MEDLINE, EMBASE, EBSCO CINAHL, the bibliographies of identified articles, orthopaedic meeting abstracts, health technology assessment web sites, and important orthopaedic journals. This search was performed for the years 1990 to the present. No language restriction was applied. We restricted our search to Level-I studies involving participants who received either an all-polyethylene or a metal-backed tibial implant. The primary outcome measures were durability, function, and adverse events. Two reviewers independently screened the papers for inclusion, assessed trial quality, and extracted data. Effects estimates were pooled with use of fixed and random-effects models of risk ratios, calculated with 95% confidence intervals. Heterogeneity was assessed with the I2 statistic. Forest plots were also generated. Data on 1798 primary total knee implants from twelve studies were analyzed. In all studies, the median or mean age of the participants was greater than sixty-seven years, with a majority of the patients being female. There was no difference between patients managed with an all-polyethylene tibial component and those managed with a metal-backed tibial component in terms of adverse events. There was no significant difference between the two groups in terms of the durability of the implants at two, ten, and fifteen years postoperatively, regardless of the year or how durability was defined (revision or radiographic failure). Finally, with use of a variety of validated

  1. [Silastic implant and synovitis].

    PubMed

    Sennwald, G

    1989-07-22

    The silastic implant based on siloxane polymere induces granulomatous synovitis in certain predisposed individuals, a reaction which may continue even after removal of the implant. This is also true of a prosthesis of the trapezium in two of our patients, though to a lesser degree. This is probably the reason why the problem has not yet been widely recognized. The hypothesis is put forward that an enzymatic predisposition may allow chemical degradation of the fragmented silastic implant into a toxic component responsible for the pathologic condition. The slow progression of the lesions is a challenge for the future and puts in question the further use of silastic implants.

  2. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  3. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  4. Penile Implants

    MedlinePlus

    Penile Implants Overview By Mayo Clinic Staff Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED ...

  5. Dental Implants.

    PubMed

    Griggs, Jason A

    2017-10-01

    Systematic reviews of literature over the period between 2008 and 2017 are discussed regarding clinical evidence for the factors affecting survival and failure of dental implants. The factors addressed include publication bias, tooth location, insertion torque, collar design, implant-abutment connection design, implant length, implant width, bone augmentation, platform switching, surface roughness, implant coatings, and the use of ceramic materials in the implant body and abutment. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Prosthodontic management of implant therapy.

    PubMed

    Thalji, Ghadeer; Bryington, Matthew; De Kok, Ingeborg J; Cooper, Lyndon F

    2014-01-01

    Implant-supported dental restorations can be screw-retained, cement-retained, or a combination of both, whereby a metal superstructure is screwed to the implants and crowns are individually cemented to the metal frame. Each treatment modality has advantages and disadvantages. The use of computer-aided design/computer-assisted manufacture technologies for the manufacture of implant superstructures has proved to be advantageous in the quality of materials, precision of the milled superstructures, and passive fit. Maintenance and recall evaluations are an essential component of implant therapy. The longevity of implant restorations is limited by their biological and prosthetic maintenance requirements.

  7. [Allergic reactions to implant materials].

    PubMed

    Thomas, P

    2003-01-01

    The extent of the immune response upon implantation of metallic devices depends on the individual reactivity and on material characteristics. If specific T-cellular sensitization occurs or an allergy to metal preexists, hypersensitive reactions to implant components may develop. They include eczema, impaired wound healing, and sterile osteomyelitis. The existence of allergy-induced implant loosening is still an open question. Further improvement of clinical allergological diagnostics, better understanding of peri-implantar immune reactions, and interdisciplinary collection of epidemiological data concerning allergy to implants will contribute to a better knowledge about tolerance of implant material in humans.

  8. A process chain for integrating piezoelectric transducers into aluminum die castings to generate smart lightweight structures

    NASA Astrophysics Data System (ADS)

    Stein, Stefan; Wedler, Jonathan; Rhein, Sebastian; Schmidt, Michael; Körner, Carolin; Michaelis, Alexander; Gebhardt, Sylvia

    The application of piezoelectric transducers to structural body parts of machines or vehicles enables the combination of passive mechanical components with sensor and actuator functions in one single structure. According to Herold et al. [1] and Staeves [2] this approach indicates significant potential regarding smart lightweight construction. To obtain the highest yield, the piezoelectric transducers need to be integrated into the flux of forces (load path) of load bearing structures. Application in a downstream process reduces yield and process efficiency during manufacturing and operation, due to the necessity of a subsequent process step of sensor/actuator application. The die casting process offers the possibility for integration of piezoelectric transducers into metal structures. Aluminum castings are particularly favorable due to their high quality and feasibility for high unit production at low cost (Brunhuber [3], Nogowizin [4]). Such molded aluminum parts with integrated piezoelectric transducers enable functions like active vibration damping, structural health monitoring or energy harvesting resulting in significant possibilities of weight reduction, which is an increasingly important driving force of automotive and aerospace industry (Klein [5], Siebenpfeiffer [6]) due to increasingly stringent environmental protection laws. In the scope of those developments, this paper focuses on the entire process chain enabling the generation of lightweight metal structures with sensor and actuator function, starting from the manufacturing of piezoelectric modules over electrical and mechanical bonding to the integration of such modules into aluminum (Al) matrices by die casting. To achieve this challenging goal, piezoceramic sensors/actuator modules, so-called LTCC/PZT modules (LPM) were developed, since ceramic based piezoelectric modules are more likely to withstand the thermal stress of about 700 °C introduced by the casting process (Flössel et al., [7]). The

  9. Implantable biomedical devices on bioresorbable substrates

    DOEpatents

    Rogers, John A; Kim, Dae-Hyeong; Omenetto, Fiorenzo; Kaplan, David L; Litt, Brian; Viventi, Jonathan; Huang, Yonggang; Amsden, Jason

    2014-03-04

    Provided herein are implantable biomedical devices, methods of administering implantable biomedical devices, methods of making implantable biomedical devices, and methods of using implantable biomedical devices to actuate a target tissue or sense a parameter associated with the target tissue in a biological environment. Each implantable biomedical device comprises a bioresorbable substrate, an electronic device having a plurality of inorganic semiconductor components supported by the bioresorbable substrate, and a barrier layer encapsulating at least a portion of the inorganic semiconductor components. Upon contact with a biological environment the bioresorbable substrate is at least partially resorbed, thereby establishing conformal contact between the implantable biomedical device and the target tissue in the biological environment.

  10. Colony stimulating factor-1 receptor is a central component of the foreign body response to biomaterial implants in rodents and non-human primates

    NASA Astrophysics Data System (ADS)

    Doloff, Joshua C.; Veiseh, Omid; Vegas, Arturo J.; Tam, Hok Hei; Farah, Shady; Ma, Minglin; Li, Jie; Bader, Andrew; Chiu, Alan; Sadraei, Atieh; Aresta-Dasilva, Stephanie; Griffin, Marissa; Jhunjhunwala, Siddharth; Webber, Matthew; Siebert, Sean; Tang, Katherine; Chen, Michael; Langan, Erin; Dholokia, Nimit; Thakrar, Raj; Qi, Meirigeng; Oberholzer, Jose; Greiner, Dale L.; Langer, Robert; Anderson, Daniel G.

    2017-06-01

    Host recognition and immune-mediated foreign body response to biomaterials can compromise the performance of implanted medical devices. To identify key cell and cytokine targets, here we perform in-depth systems analysis of innate and adaptive immune system responses to implanted biomaterials in rodents and non-human primates. While macrophages are indispensable to the fibrotic cascade, surprisingly neutrophils and complement are not. Macrophages, via CXCL13, lead to downstream B cell recruitment, which further potentiated fibrosis, as confirmed by B cell knockout and CXCL13 neutralization. Interestingly, colony stimulating factor-1 receptor (CSF1R) is significantly increased following implantation of multiple biomaterial classes: ceramic, polymer and hydrogel. Its inhibition, like macrophage depletion, leads to complete loss of fibrosis, but spares other macrophage functions such as wound healing, reactive oxygen species production and phagocytosis. Our results indicate that targeting CSF1R may allow for a more selective method of fibrosis inhibition, and improve biomaterial biocompatibility without the need for broad immunosuppression.

  11. Biomimetic approach to dental implants.

    PubMed

    Kim, Tae-Il; Jang, Jun-Hyeog; Kim, Hae-Won; Knowles, Jonathan C; Ku, Young

    2008-01-01

    Titanium, as an implant material, is regarded to be durable and biocompatible, which allows functional replacement of missing teeth. Successful dental implantation depends on an osseointegration phenomenon, a direct structural and functional binding reaction between bone and implant. It is well known that physicochemical characteristics of the dental implant surface, such as roughness, topography, chemistry, and electrical charge affect the biological reactions occurring at the interface of tissue and implant. Therefore, considerable efforts have been made to modify the surface of titanium implants which are based on mechanical, physical and chemical treatments. Recently, biological molecules were introduced onto the surface of implants to stimulate osteogenic cells in the early stage of implantation and consequently accelerate bone formation around implant and subsequent rapid implant stabilization. A range of extracellular matrix components, designed peptides, and growth factors have been proposed as the biological moiety. In this review, we address several issues related to the biology of dental implants and discuss biomimetic modification of the implant surface as a novel approach to obtain successful osseointegration.

  12. Dental Implants.

    PubMed

    Zohrabian, Vahe M; Sonick, Michael; Hwang, Debby; Abrahams, James J

    2015-10-01

    Dental implants restore function to near normal in partially or completely edentulous patients. A root-form implant is the most frequently used type of dental implant today. The basis for dental implants is osseointegration, in which osteoblasts grow and directly integrate with the surface of titanium posts surgically embedded into the jaw. Radiologic assessment is critical in the preoperative evaluation of the dental implant patient, as the exact height, width, and contour of the alveolar ridge must be determined. Moreover, the precise locations of the maxillary sinuses and mandibular canals, as well as their relationships to the site of implant surgery must be ascertained. As such, radiologists must be familiar with implant design and surgical placement, as well as augmentation procedures utilized in those patients with insufficient bone in the maxilla and mandible to support dental implants.

  13. Penile Implants

    MedlinePlus

    ... Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and ... an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve ...

  14. Hydroxylapatite Otologic Implants

    SciTech Connect

    McMillan, A.D.; Lauf, R.J.; Beale, B.; Johnson, R.

    2000-01-01

    A Cooperative Research and Development Agreement (CRADA) between Lockheed Martin Energy Research Corporation (LMER) and Smith and Nephew Richards Inc. of Bartlett, TN, was initiated in March 1997. The original completion date for the Agreement was March 25, 1998. The purpose of this work is to develop and commercialize net shape forming methods for directly creating dense hydroxylapatite (HA) ceramic otologic implants. The project includes three tasks: (1) modification of existing gelcasting formulations to accommodate HA slurries; (2) demonstration of gelcasting to fabricate green HA ceramic components of a size and shape appropriate to otologic implants: and (3) sintering and evaluation of the HA components.

  15. Sequential release kinetics of two (gentamicin and BMP-2) or three (gentamicin, IGF-I and BMP-2) substances from a one-component polymeric coating on implants.

    PubMed

    Strobel, Catrin; Bormann, Nicole; Kadow-Romacker, Anke; Schmidmaier, Gerhard; Wildemann, Britt

    2011-11-30

    The local application of antibiotics in combination with timely controlled growth factor delivery might be beneficial for the prevention of infections and to stimulate bone healing. Therefore, in this study a variable sequential drug delivery system with three distinctly different release profiles was developed: i) a burst release of gentamicin, ii) a burst release of IGF-I followed by a sustained release, and iii) a slow sustained release of BMP-2 out of an implant coating. Only one polymer [poly(D,L-lactide)], incorporating gentamicin, IGF-I or BMP-2, was used for two- or three-layer coatings of K-wires. To control the release kinetics, the polymer concentrations in the solvent were varied. The activity of early released gentamicin from a two-layer coating was confirmed microbiologically and BMP-2 stimulated the metabolic activity and alkaline phosphatase activity of C2C12 cells after 2 weeks. From the three-layer coated wires, IGF-I continuously stimulated the cell proliferation, whereas BMP-2 enhanced ALP between 1 and 3 weeks. The sequential release of growth factors revealed an additive effect on the metabolic activity and ALP of primary osteoblast-like cells compared to the single coated controls. The controlled delivery of different factors from one implant might prevent infections and subsequently stimulate the different phases of bone healing.

  16. Establishment of a green fluorescent protein tracing murine model focused on the functions of host components in necrosis repair and the niche of subcutaneously implanted glioma.

    PubMed

    Lu, Zhao-Hui; Lv, Ke; Zhang, Jin-Shi; Dai, Chun-Gang; Liu, Bin; Ma, Xiao-Yu; He, Lin-Ming; Jia, Jing-Yun; Chen, Yan-Ming; Dai, Xing-Liang; Wang, Ai-Dong; Dong, Jun; Zhang, Quan-Bin; Lan, Qing; Huang, Qiang

    2014-02-01

    Due to progress in the research of glioma stem cells and the glioma niche, development of an animal model that facilitates the elucidation of the roles of the host tissue and cells is necessary. The aim of the present study was to develop a subcutaneous xenograft green fluorescent protein nude mouse model and use this model to analyze the roles of host cells in tumor necrosis repair. Tumors derived from the human glioma stem/progenitor cell line SU3 were subcutaneously implanted in green fluorescent protein nude mice. The implanted tumors were then passed from animal to animal for 10 generations. Finally, subcutaneous xenografts were assayed with traditional pathology, immunopathological techniques and fluorescence photography. For each generation, the tumorigenicity rate was 100%. Subcutaneous xenografts were rich in blood vessels, and necrotic and hemorrhagic foci, which highly expressed hypoxia-inducible factor-1α, tumor necrosis factor, Ki-67, CD68 and CD11b. In the interstitial tissue, particularly in old hemorrhagic foci, there were numerous cells expressing green fluorescent protein, CD68 and CD11b. Green fluorescent protein nude mouse subcutaneous xenografts not only consistently maintained the high invasiveness and tumorigenicity of glioma stem/progenitor cells, but also consisted of a high concentration of tumor blood vessels and necrotic and hemorrhagic foci. Subcutaneous xenografts also expressed high levels of tumor microenvironment-related proteins and host-derived tumor interstitial molecules. The model has significant potential for further research on tumor tissue remodeling and the tumor microenvironment.

  17. Nanotechnology for dental implants.

    PubMed

    Tomsia, Antoni P; Lee, Janice S; Wegst, Ulrike G K; Saiz, Eduardo

    2013-01-01

    With the advent of nanotechnology, an opportunity exists for the engineering of new dental implant materials. Metallic dental implants have been successfully used for decades, but they have shortcomings related to osseointegration and mechanical properties that do not match those of bone. Absent the development of an entirely new class of materials, faster osseointegration of currently available dental implants can be accomplished by various surface modifications. To date, there is no consensus regarding the preferred method(s) of implant surface modification, and further development will be required before the ideal implant surface can be created, let alone become available for clinical use. Current approaches can generally be categorized into three areas: ceramic coatings, surface functionalization, and patterning on the micro- to nanoscale. The distinctions among these are imprecise, as some or all of these approaches can be combined to improve in vivo implant performance. These surface improvements have resulted in durable implants with a high percentage of success and long-term function. Nanotechnology has provided another set of opportunities for the manipulation of implant surfaces in its capacity to mimic the surface topography formed by extracellular matrix components of natural tissue. The possibilities introduced by nanotechnology now permit the tailoring of implant chemistry and structure with an unprecedented degree of control. For the first time, tools are available that can be used to manipulate the physicochemical environment and monitor key cellular events at the molecular level. These new tools and capabilities will result in faster bone formation, reduced healing time, and rapid recovery to function.

  18. Using Aerospace Technology To Design Orthopedic Implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  19. Using Aerospace Technology To Design Orthopedic Implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1996-01-01

    Technology originally developed to optimize designs of composite-material aerospace structural components used to develop method for optimizing designs of orthopedic implants. Development effort focused on designing knee implants, long-term goal to develop method for optimizing designs of orthopedic implants in general.

  20. Implantable Microimagers

    PubMed Central

    Ng, David C.; Tokuda, Takashi; Shiosaka, Sadao; Tano, Yasuo; Ohta, Jun

    2008-01-01

    Implantable devices such as cardiac pacemakers, drug-delivery systems, and defibrillators have had a tremendous impact on the quality of live for many disabled people. To date, many devices have been developed for implantation into various parts of the human body. In this paper, we focus on devices implanted in the head. In particular, we describe the technologies necessary to create implantable microimagers. Design, fabrication, and implementation issues are discussed vis-à-vis two examples of implantable microimagers; the retinal prosthesis and in vivo neuro-microimager. Testing of these devices in animals verify the use of the microimagers in the implanted state. We believe that further advancement of these devices will lead to the development of a new method for medical and scientific applications. PMID:27879873

  1. High Productivity Implantation ''PARTIAL IMPLANT''

    SciTech Connect

    Hino, Masayoshi; Miyamoto, Naoki; Sakai, Shigeki; Matsumoto, Takao

    2008-11-03

    The patterned ion implantation 'PARTIAL IMPLANT' has been developed as a productivity improvement tool. The Partial Implant can form several different ion dose areas on the wafer surface by controlling the speed of wafer moving and the stepwise rotation of twist axis. The Partial Implant system contains two implant methods. One method is 'DIVIDE PARTIAL IMPLANT', that is aimed at reducing the consumption of the wafer. The Divide Partial Implant evenly divides dose area on one wafer surface into two or three different dose part. Any dose can be selected in each area. So the consumption of the wafer for experimental implantation can be reduced. The second method is 'RING PARTIAL IMPLANT' that is aimed at improving yield by correcting electrical characteristic of devices. The Ring Partial Implant can form concentric ion dose areas. The dose of wafer external area can be selected to be within plus or minus 30% of dose of wafer central area. So the electrical characteristic of devices can be corrected by controlling dose at edge side on the wafer.

  2. Choice of a dental implant system.

    PubMed

    Hunt, Peter R; Gartner, Judith L; Norkin, Frederic J

    2005-04-01

    Many dentists are bewildered by the intricacies and complexities of dental implants. They are constantly besieged by product advertisements and can find it difficult to choose which systems to work with. Some dentists are so intimidated by the subject that they choose to avoid getting involved with implants and instead stick to traditional tooth replacement systems. By breaking implants down into 4 main components, the body, collar, connection, and restorative post, it is easier to understand the structure and function of dental implants. Each portion should be designed to achieve certain objectives. Once these structural components are understood, it is easier to compare and contrast differing implant systems.

  3. Endodontic implants

    PubMed Central

    Yadav, Rakesh K.; Tikku, A. P.; Chandra, Anil; Wadhwani, K. K.; Ashutosh kr; Singh, Mayank

    2014-01-01

    Endodontic implants were introduced back in 1960. Endodontic implants enjoyed few successes and many failures. Various reasons for failures include improper case selection, improper use of materials and sealers and poor preparation for implants. Proper case selection had given remarkable long-term success. Two different cases are being presented here, which have been treated successfully with endodontic implants and mineral trioxide aggregate Fillapex (Andreaus, Brazil), an MTA based sealer. We suggest that carefully selected cases can give a higher success rate and this method should be considered as one of the treatment modalities. PMID:25298723

  4. Biomaterials in cochlear implants

    PubMed Central

    Stöver, Timo; Lenarz, Thomas

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103

  5. Management of peri-implant mucositis and peri-implantitis.

    PubMed

    Figuero, Elena; Graziani, Filippo; Sanz, Ignacio; Herrera, David; Sanz, Mariano

    2014-10-01

    Peri-implant diseases are defined as inflammatory lesions of the surrounding peri-implant tissues and include peri-implant mucositis (an inflammatory lesion limited to the surrounding mucosa of an implant) and peri-implantitis (an inflammatory lesion of the mucosa that affects the supporting bone with resulting loss of osseointegration). This review aims to describe the different approaches to manage both entities and to provide a critical evaluation of the evidence available on their efficacy. Therapy of peri-implant mucositis and nonsurgical therapy of peri-implantitis usually involve mechanical debridement of the implant surface using curettes, ultrasonic devices, air-abrasive devices or lasers, with or without the adjunctive use of local antibiotics or antiseptics. The efficacy of these therapies has been demonstrated for mucositis: controlled clinical trials show an improvement in clinical parameters, especially in bleeding on probing. For peri-implantitis, the results are limited, especially in terms of probing pocket-depth reduction. Surgical therapy of peri-implantitis is indicated when nonsurgical therapy fails to control the inflammatory changes. Selection of the surgical technique should be based on the characteristics of the peri-implant lesion. In the presence of deep circumferential and intrabony defects, surgical interventions should aim to provide thorough debridement, implant-surface decontamination and defect reconstruction. In the presence of defects without clear bony walls or with a predominant suprabony component, the aim of the surgical intervention should be the thorough debridement and the repositioning of the marginal mucosa to enable the patient to perform effective oral-hygiene practices, although this aim may compromise the esthetic result of the implant-supported restoration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Experimental immunotherapy of human breast carcinomas implanted in nude mice with a mixture of monoclonal antibodies against human milk fat globule components.

    PubMed

    Ceriani, R L; Blank, E W; Peterson, J A

    1987-01-15

    Immunological therapy of BALB/c nude mice (nu/nu) implanted with human breast tumors, estrogen receptor negative MX-1 and estrogen receptor-positive MCF-7, was carried out with four monoclonal antibodies (MoAbs) raised against human milk fat globule membrane glycoproteins also present on normal breast epithelial cells. MoAbs injected singly or as a partial mixture arrested growth of the tumors but to a lesser extent than a mixture ("cocktail") of all four MoAbs. Two model systems were developed in order to examine the capabilities of the four MoAbs to arrest human mammary tumor growth. In the first model the ability of these MoAbs to arrest tumor growth during a 6- to 8-week period was tested by injection of the MoAbs immediately before and after implantation (passive immunization) and thereafter every other day. In the second model the effect of these MoAbs on established and growing tumors was tested. Using the cocktail in the passive immunization protocol, human mammary tumor growth in nu/nu mice was arrested either completely or averaging to one-tenth the size of the controls for those mice in which the tumors had taken. Other human carcinomas, colon and lung, under the same protocol, were not affected. Injection of cocktail every 2 days into nu/nu mice with established and growing human breast tumors (both estrogen receptor positive and negative) produced arrests of tumor growth of 44.1, 45.2, 49.8% of their controls after 7 to 8 days of treatment. Previously, it has been established that human mammary tumors are heterogeneous in expression of the human milk fat globule antigens recognized by our antibodies to the extent that some cells may have large amounts and others no detectable amount of a particular antigen. Those MX-1 tumors treated for a prolonged time with the cocktail of MoAbs that survived and continued to grow could be the result of the preferential multiplication of those cells in the heterogeneous population which had low or no antigen content

  7. Custom Cast Ball Attachments Used on Outdated Implants to Restore a Maxillary Implant-Supported Overdenture.

    PubMed

    Leite, Andressa Rosa Perin; Marin, Danny Omar Mendoza; Giro, Gabriela; Pero, Ana Carolina; Pinelli, Ligia Antunes Pereira; Reis, José Maurício Dos Santos Nunes

    2017-08-01

    The lack of compatible prosthetic components can be a complication during oral rehabilitation using outdated implants. The aim of the present clinical report was to describe an alternative technique for the fabrication of a maxillary implant-supported overdenture in a patient with 20-year-old dental implants using castable spherical patterns and ball attachments. The patient had been wearing a relined bar/clip overdenture in the mandible on 4 external-hexagon dental implants and a relined complete denture in the maxilla on 4 internal-hexagon implants due to abutment screw fracture inside of the implants, losing the attachment system. The remaining maxillary dental implants did not possess attachments compatible with current systems due to configuration changes by the manufacturer in the dental implant's platform and the components over time. Therefore, castable spherical patterns and cast ball attachments were used to fabricate a maxillary implant-supported overdenture. The mandible rehabilitation was performed using 4 osseointegrated dental implants with a fixed implant-supported prosthesis. The use of cast ball attachments on the maxillary dental implants avoided invasive procedures on the remaining implants. Considering the lack of available compatible prosthetic components for the osseointegrated implants, this technique was considered a viable and satisfactory treatment option.

  8. The Effects of Musical and Linguistic Components in Recognition of Real-World Musical Excerpts by Cochlear Implant Recipients and Normal-Hearing Adults

    PubMed Central

    Gfeller, Kate; Jiang, Dingfeng; Oleson, Jacob; Driscoll, Virginia; Olszewski, Carol; Knutson, John F.; Turner, Christopher; Gantz, Bruce

    2011-01-01

    Background Cochlear implants (CI) are effective in transmitting salient features of speech, especially in quiet, but current CI technology is not well suited in transmission of key musical structures (e.g., melody, timbre). It is possible, however, that sung lyrics, which are commonly heard in real-world music may provide acoustical cues that support better music perception. Objective The purpose of this study was to examine how accurately adults who use CIs (n=87) and those with normal hearing (NH) (n=17) are able to recognize real-world music excerpts based upon musical and linguistic (lyrics) cues. Results CI recipients were significantly less accurate than NH listeners on recognition of real-world music with or, in particular, without lyrics; however, CI recipients whose devices transmitted acoustic plus electric stimulation were more accurate than CI recipients reliant upon electric stimulation alone (particularly items without linguistic cues). Recognition by CI recipients improved as a function of linguistic cues. Methods Participants were tested on melody recognition of complex melodies (pop, country, classical styles). Results were analyzed as a function of: hearing status and history, device type (electric only or acoustic plus electric stimulation), musical style, linguistic and musical cues, speech perception scores, cognitive processing, music background, age, and in relation to self-report on listening acuity and enjoyment. Age at time of testing was negatively correlated with recognition performance. Conclusions These results have practical implications regarding successful participation of CI users in music-based activities that include recognition and accurate perception of real-world songs (e.g., reminiscence, lyric analysis, listening for enjoyment). PMID:22803258

  9. The effects of musical and linguistic components in recognition of real-world musical excerpts by cochlear implant recipients and normal-hearing adults.

    PubMed

    Gfeller, Kate; Jiang, Dingfeng; Oleson, Jacob J; Driscoll, Virginia; Olszewski, Carol; Knutson, John F; Turner, Christopher; Gantz, Bruce

    2012-01-01

    Cochlear implants (CI) are effective in transmitting salient features of speech, especially in quiet, but current CI technology is not well suited in transmission of key musical structures (e.g., melody, timbre). It is possible, however, that sung lyrics, which are commonly heard in real-world music may provide acoustical cues that support better music perception. The purpose of this study was to examine how accurately adults who use CIs (n = 87) and those with normal hearing (NH) (n = 17) are able to recognize real-world music excerpts based upon musical and linguistic (lyrics) cues. CI recipients were significantly less accurate than NH listeners on recognition of real-world music with or, in particular, without lyrics; however, CI recipients whose devices transmitted acoustic plus electric stimulation were more accurate than CI recipients reliant upon electric stimulation alone (particularly items without linguistic cues). Recognition by CI recipients improved as a function of linguistic cues. Participants were tested on melody recognition of complex melodies (pop, country, & classical styles). Results were analyzed as a function of: hearing status and history, device type (electric only or acoustic plus electric stimulation), musical style, linguistic and musical cues, speech perception scores, cognitive processing, music background, age, and in relation to self-report on listening acuity and enjoyment. Age at time of testing was negatively correlated with recognition performance. These results have practical implications regarding successful participation of CI users in music-based activities that include recognition and accurate perception of real-world songs (e.g., reminiscence, lyric analysis, & listening for enjoyment).

  10. About Implantable Contraception

    MedlinePlus

    ... TV, Video Games, and the Internet About Implantable Contraception KidsHealth > For Parents > About Implantable Contraception Print A ... How Much Does It Cost? What Is Implantable Contraception? Implantable contraception (often called the birth control implant) ...

  11. Towards biodegradable wireless implants.

    PubMed

    Boutry, Clémentine M; Chandrahalim, Hengky; Streit, Patrick; Schinhammer, Michael; Hänzi, Anja C; Hierold, Christofer

    2012-05-28

    A new generation of partially or even fully biodegradable implants is emerging. The idea of using temporary devices is to avoid a second surgery to remove the implant after its period of use, thereby improving considerably the patient's comfort and safety. This paper provides a state-of-the-art overview and an experimental section that describes the key technological challenges for making biodegradable devices. The general considerations for the design and synthesis of biodegradable components are illustrated with radiofrequency-driven resistor-inductor-capacitor (RLC) resonators made of biodegradable metals (Mg, Mg alloy, Fe, Fe alloys) and biodegradable conductive polymer composites (polycaprolactone-polypyrrole, polylactide-polypyrrole). Two concepts for partially/fully biodegradable wireless implants are discussed, the ultimate goal being to obtain a fully biodegradable sensor for in vivo sensing.

  12. Surface modification of implants in long bone.

    PubMed

    Förster, Yvonne; Rentsch, Claudia; Schneiders, Wolfgang; Bernhardt, Ricardo; Simon, Jan C; Worch, Hartmut; Rammelt, Stefan

    2012-01-01

    Coatings of orthopedic implants are investigated to improve the osteoinductive and osteoconductive properties of the implant surfaces and thus to enhance periimplant bone formation. By applying coatings that mimic the extracellular matrix a favorable environment for osteoblasts, osteoclasts and their progenitor cells is provided to promote early and strong fixation of implants. It is known that the early bone ongrowth increases primary implant fixation and reduces the risk of implant failure. This review presents an overview of coating titanium and hydroxyapatite implants with components of the extracellular matrix like collagen type I, chondroitin sulfate and RGD peptide in different small and large animal models. The influence of these components on cells, the inflammation process, new bone formation and bone/implant contact is summarized.

  13. Hidden Overdenture Bar in Fixed Implant-retained Hybrid Prosthesis: Report of a Novel Technique.

    PubMed

    Shetty, Prajna P; Gangaiah, Makam; Chowdhary, Ramesh

    2016-09-01

    Every patient needs a comprehensive treatment planning. Dentists must consider the advantages and disadvantages of the available implant prosthetic options and match them to patient's expectations. Hybrid denture prosthesis is one, i.e., fabricated and retained by screw threaded into implant abutments, most of the time on four implants. Sometimes due to failure of an implant, the prosthesis needs to be replaced with a newer casting to accommodate the existing implants. Clinical consideration: This article presents a novel technique, wherein the existing framework of the fixed prosthesis can be used to convert the fixed prosthesis to removable prosthesis on the existing implants, without recasting. The implant is economical and easily convertible from a fixed-fixed to a fixed-removable prosthesis. Hence, there is reduced morbidity, reduced cost, and an increased psychological comfort for the patient.

  14. Equicrestal and subcrestal dental implants: a histologic and histomorphometric evaluation of nine retrieved human implants.

    PubMed

    Degidi, Marco; Perrotti, Vittoria; Shibli, Jamil A; Novaes, Arthur B; Piattelli, Adriano; Iezzi, Giovanna

    2011-05-01

    Stability of peri-implant crestal bone plays a relevant role relative to the presence or absence of interdental papilla. Several factors can contribute to the crestal bone resorption observed around two-piece implants, such as the presence of a microgap at the level of the implant-abutment junction, the type of connection between implant and prosthetic components, the implant positioning relative to the alveolar crest, and the interimplant distance. Subcrestal positioning of dental implants has been proposed to decrease the risk of exposure of the metal of the top of the implant or of the abutment margin, and to get enough space in a vertical dimension to create a harmoniously esthetic emergence profile. The present retrospective histologic study was performed to evaluate dental implants retrieved from human jaws that had been inserted in an equicrestal or subcrestal position. A total of nine implants were evaluated: five of these had been inserted in an equicrestal position, whereas the other four had been positioned subcrestally (1 to 3 mm). In all subcrestally placed implants, preexisting and newly formed bone was found over the implant shoulder. In the equicrestal implants, crestal bone resorption (0.5 to 1.5 mm) was present around all implants. The subcrestal position of the implants resulted in bone located above the implant shoulder.

  15. Cochlear implant

    MedlinePlus

    ... bilateral cochlear implantation: a review. Curr Opin Otolaryngol Head Neck Surg . 2007;15(5):315-318. PMID: 17823546. ... BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  16. Histrelin Implant

    MedlinePlus

    ... implant (Supprelin LA) is used to treat central precocious puberty (CPP; a condition causing children to enter puberty too soon, resulting in faster than normal bone growth and development of sexual characteristics) in girls ...

  17. Breast Implants

    MedlinePlus

    ... in the United States: saline-filled and silicone gel-filled. Both types have a silicone outer shell. ... them. Provide information on saline-filled and silicone gel-filled breast implants, including data supporting a reasonable ...

  18. Cochlear implants.

    PubMed

    Connell, Sarah S; Balkany, Thomas J

    2006-08-01

    Cochlear implants are cost-effective auditory prostheses that safely provide a high-quality sensation of hearing to adults who are severely or profoundly deaf. In the past 5 years, progress has been made in hardware and software design, candidate selection, surgical techniques, device programming, education and rehabilitation,and, most importantly, outcomes. Cochlear implantation in the elderly is well tolerated and provides marked improvement in auditory performance and psychosocial functioning.

  19. Prediction of individual implant bone levels and the existence of implant "phenotypes".

    PubMed

    Papantonopoulos, Georgios; Gogos, Christos; Housos, Efthymios; Bountis, Tassos; Loos, Bruno G

    2017-07-01

    To cluster implants placed in patients of a private practice and identify possible implant "phenotypes" and predictors of individual implant mean bone levels (IIMBL). Clinical and radiographical variables were collected from 72 implant-treated patients with 237 implants and a mean 7.4 ± 3.5 years of function. We clustered implants using the k-means method guided by multidimensional unfolding. For predicting IIMBL, we used principal component analysis (PCA) as a variable reduction method for an ensemble selection (ES) and a support vector machines models (SVMs). Network analysis investigated variable interactions. We identified a cluster of implants susceptible to peri-implantitis (96% of the implants in the cluster were affected by peri-implantitis) and two overlapping clusters of implants resistant to peri-implantitis. The cluster susceptible to peri-implantitis showed a mean IIMBL of 5.2 mm and included implants placed mainly in the lower front jaw and in mouths having a mean of eight teeth. PCA extracted the parameters such as number of teeth, full-mouth plaque scores, implant surface, periodontitis severity, age and diabetes as significant in explaining the data variability. ES and SVMs showed good results in predicting IIMBL (root-mean-squared error of 0.133 and 0.149, 10-fold cross-validation error of 0.147 and 0.150, respectively). Network analysis revealed limited interdependencies of variables among peri-implantitis-affected and non-affected implants and supported the hypothesis of the existence of distinct implant "phenotypes." Two implant "phenotypes" were identified, one with susceptibility and another with resistance to peri-implantitis. Prediction of IIMBL could be achieved by using six variables. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Contraceptive implants.

    PubMed

    McDonald-Mosley, Raegan; Burke, Anne E

    2010-03-01

    Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe for use by women with many chronic medical problems. The newest implant, Implanon (Organon International, Oss, The Netherlands), is the only device currently available in the United States and was approved in 2006. It is registered for 3 years of pregnancy prevention. Contraceptive implants have failure rates similar to tubal ligation, and yet they are readily reversible with a return to fertility within days of removal. Moreover, these contraceptive devices can be safely placed in the immediate postpartum period, ensuring good contraceptive coverage for women who may be at risk for an unintended pregnancy. Irregular bleeding is a common side effect for all progestin-only contraceptive implants. Preinsertion counseling should address possible side effects, and treatment may be offered to women who experience prolonged or frequent bleeding.

  1. [Effect of the number and inclination of implant on stress distribution for mandibular full-arch fixed prosthesis].

    PubMed

    Zheng, Xiaoying; Li, Xiaomei; Tang, Zhen; Gong, Lulu; Wang, Dalin

    2014-06-01

    To study the effect of implant number and inclination on stress distribution in implant and its surrounding bone with three-dimensional finite element analysis. A special denture was made for an edentulous mandible cast to collect three-dimensional finite element data. Three three-dimensional finite element models were established as follows. Model 1: 6 paralleled implants; model 2: 4 paralleled implants; model 3: 4 implants, the two anterior implants were parallel, the two distal implants were tilted 30° distally. Among the three models, the maximum stress values found in anterior implants, posterior implants, and peri-implant bone were modle 3implant numbers on stress distribution was as follow: the maximum stress value of the anterior and posterior implant, and the peri-implant bone of model 2 were 126.8, 267.4, and 40.0 MPa, which was 35.8%, 3.8% and 7.8% higher than those in model 1 (93.4, 257.7, 37.1 MPa) respectively. The impact of implant inclination on stress distribution was as follow: when the distal implant titled 30° in model 3, the maximum stress value of the anterior and posterior implant, and the peri-implant bone were 82.0, 239.5 and 28.7 MPa, which was 35.4%, 10.5% and 28.2% lower than those in model 2 respectively. Within the limitation of this study, when implants are placed parallel, the maximum stress of the distal implant can be reduced by increasing the number of implant.When the number of implant was decreased from six to four, the maximum stress around the implant can be reduced by tilting the distal implant. This design will provide a better prostheses effect than the design with six implants does.

  2. Early History and Challenges of Implantable Electronics

    PubMed Central

    KO, WEN H.

    2013-01-01

    Implantable systems for biomedical research and clinical care are now a flourishing field of activities in academia as well as industrial institutions. The broad field includes experimental explorations in electronics, mechanical, chemical, and biological components and systems, and the combination of all these. Today virtually all implants involve both electronic circuits and micro-electro-mechanical-systems (MEMS). This article offers a very brief glance back at the early history of implant electronics in the period from the 1950s to the 1970s, by employing selected examples from the author’s research. This short review also discusses the challenges of implantable electronics at present, and suggests some potentially important trends in the future research and development of implantable microsystems. It is aimed as an introduction of implantable/attached electronic systems to research engineers that are interested in implantable systems as a section of Biomedical Instrumentations. PMID:24791159

  3. Cochlear Implants

    MedlinePlus

    ... outside of the body, behind the ear. A second part is surgically placed under the skin. An implant does not restore normal hearing. It can help a person understand speech. Children and adults can benefit from them. National Institute on Deafness and Other Communication Disorders

  4. [Bruxism and overload of periodontium and implants].

    PubMed

    Jacobs, R; De Laat, A

    2000-07-01

    Bruxism is responsible for occlusal tooth wear but can not induce nor aggravate gingivitis or periodontitis. Bruxism induces jiggling forces, which cause a clinical tooth hypermobility, radiologically seen as a widened periodontal space. Although there is no direct causal relation between bruxism and implant failure, implant overload may lead to fractures of the components and bone loss.

  5. Short Implants: New Horizon in Implant Dentistry

    PubMed Central

    Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-01-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration. PMID:27790598

  6. Short Implants: New Horizon in Implant Dentistry.

    PubMed

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

  7. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  8. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  9. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  10. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  11. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component...

  12. Evaluation of Evoked Potentials to Dyadic Tones after Cochlear Implantation

    ERIC Educational Resources Information Center

    Sandmann, Pascale; Eichele, Tom; Buechler, Michael; Debener, Stefan; Jancke, Lutz; Dillier, Norbert; Hugdahl, Kenneth; Meyer, Martin

    2009-01-01

    Auditory evoked potentials are tools widely used to assess auditory cortex functions in clinical context. However, in cochlear implant users, electrophysiological measures are challenging due to implant-created artefacts in the EEG. Here, we used independent component analysis to reduce cochlear implant-related artefacts in event-related EEGs of…

  13. Evaluation of Evoked Potentials to Dyadic Tones after Cochlear Implantation

    ERIC Educational Resources Information Center

    Sandmann, Pascale; Eichele, Tom; Buechler, Michael; Debener, Stefan; Jancke, Lutz; Dillier, Norbert; Hugdahl, Kenneth; Meyer, Martin

    2009-01-01

    Auditory evoked potentials are tools widely used to assess auditory cortex functions in clinical context. However, in cochlear implant users, electrophysiological measures are challenging due to implant-created artefacts in the EEG. Here, we used independent component analysis to reduce cochlear implant-related artefacts in event-related EEGs of…

  14. R&D on dental implants breakage

    NASA Astrophysics Data System (ADS)

    Croitoru, Sorin Mihai; Popovici, Ion Alexandru

    2017-09-01

    Most used dental implants for human dental prostheses are of two steps type: first step means implantation and, after several months healing and osseointegration, second step is prosthesis fixture. For sure, dental implants and prostheses are meant to last for a lifetime. Still, there are unfortunate cases when dental implants break. This paper studies two steps dental implants breakage and proposes a set of instruments for replacement and restoration of the broken implant. First part of the paper sets the input data of the study: structure of the studied two steps dental implants based on two Romanian patents and values of the loading forces found in practice and specialty papers. In the second part of the paper, using DEFORM 2D™ FEM simulation software, worst case scenarios of loading dental implants are studied in order to determine which zones and components of the dental implant set are affected (broken). Last part of the paper is dedicated to design and presentation of a set for extracting and cutting tools used to restore the broken implant set.

  15. Implantable medical sensor system

    DOEpatents

    Darrow, Christopher B.; Satcher, Jr., Joe H.; Lane, Stephen M.; Lee, Abraham P.; Wang, Amy W.

    2001-01-01

    An implantable chemical sensor system for medical applications is described which permits selective recognition of an analyte using an expandable biocompatible sensor, such as a polymer, that undergoes a dimensional change in the presence of the analyte. The expandable polymer is incorporated into an electronic circuit component that changes its properties (e.g., frequency) when the polymer changes dimension. As the circuit changes its characteristics, an external interrogator transmits a signal transdermally to the transducer, and the concentration of the analyte is determined from the measured changes in the circuit. This invention may be used for minimally invasive monitoring of blood glucose levels in diabetic patients.

  16. The breast implant controversy.

    PubMed

    Cook, R R; Harrison, M C; LeVier, R R

    1994-02-01

    The breast implant issue is a "bad news/good news" story. For many women with implants, the controversy has caused a fair degree of anxiety which may or may not be resolved as further information becomes available. It has also taken its toll on Dow Corning. Whole lines of medical products have been eliminated or are being phase out. The development of new medical applications has been terminated. As a consequence, employees have lost their jobs. What the effect will be on the biomedical industry as a whole remains to be seen (11). While silicones have been an important component in various medical devices, it is likely that other materials can be used as replacements. However, suppliers of non-silicone materials are also reevaluating their role in this market. For example, Du Pont, the nation's largest chemical company, has determined that the unpredictable and excessive costs of doing business with manufacturers of implantable medical devices no longer justifies the unrestricted sale of standard raw materials into this industry. Other companies are quietly following suit. On the up side, it is possible that the research being driven by this controversy will result in a greater understanding of the immunologic implications of xenobiotics, of the importance of nonbiased observations, of the need for ready access to valid data sets, and of the opportunity for valid scientific information to guide legal decisions. Only time will tell.

  17. Dental Implant Surgery

    MedlinePlus

    Dental implant surgery Overview By Mayo Clinic Staff Dental implant surgery is a procedure that replaces tooth roots ... that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures ...

  18. Hip Implant Systems

    MedlinePlus

    ... Medical Devices Products and Medical Procedures Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share ... femoral head) is removed and replaced with a prosthetic ball made of metal or ceramic, and the ...

  19. [Cochlear implants].

    PubMed

    Lehnhardt, E; Battmer, R D; Nakahodo, K; Laszig, R

    1986-07-01

    Since the middle of 1984, the HNO-Klinik der Medizinischen Hochschule Hannover has provided deaf adults with a 22-channel cochlear implant (CI) device of Clark-NUCLEUS. The digital working system consists of an implantable stimulator/receiver and an externally worn speech processor. Energy and signals are transmitted transcutaneously via a transmitter coil. During the prevailing 26 operations (April 1986) the electrode array could be inserted at least 17 mm into the cochlea. The threshold and comfort levels of all patients were adjusted very quickly; the dynamic range usually grows during the first postoperative weeks. The individual rehabilitation results vary greatly, but all patients show a significant increase of vowel and consonant comprehension while using the speech processor and an improvement of words understood per minute in speech tracking from lip-reading alone to lip-reading with speech processor. Four months after surgery seven of 17 patients (group I) are able to understand on average 42.7 words per minute by speech tracking without lip-reading. Six patients (group II) recognise 69.2% of vowels and 42.5% of consonants by speech processor alone. Four patients (group III) can correctly repeat only vowels (52.3%) without lip-reading, but using the speech processor together with lip reading they have an improvement in consonant understanding of 37.9% and under freefield conditions they are able to understand up to 17.8% numbers of the Freiburg speech test.

  20. Implant marketing: cost effective implant dentistry.

    PubMed

    Wohrle, P S; Levin, R P

    1996-01-01

    The application of the KAL-Technique to the field of implant dentistry allows both patients and dental practices to benefit. It is an exciting advance that decreases frustration and stress in providing implant procedures and lowers overall costs. Professionals using the KAL-Technique report significant predictability in achieving passive framework fit. They are also lowering overall cost of implant cases, which increases the number of patients who can accept implant treatment. It has been well established that the more individuals in a practice that receive implants, the more referrals a practice will gain. This is because implant patients find tremendous advances in the quality of life, and do not hesitate to tell others who can take advantage of this opportunity. Implant dentistry is one of the fastest growing fields in dentistry today. While some other areas of dentistry begin to decline in volume and need, implant dentistry provides the opportunity to keep practices strong and to insure long-term success.

  1. Effects of implant system, impression technique, and impression material on accuracy of the working cast.

    PubMed

    Wegner, Kerstin; Weskott, Katharina; Zenginel, Martha; Rehmann, Peter; Wöstmann, Bernd

    2013-01-01

    This in vitro study aimed to identify the effects of the implant system, impression technique, and impression material on the transfer accuracy of implant impressions. The null hypothesis tested was that, in vitro and within the parameters of the experiment, the spatial relationship of a working cast to the placement of implants is not related to (1) the implant system, (2) the impression technique, or (3) the impression material. A steel maxilla was used as a reference model. Six implants of two different implant systems (Standard Plus, Straumann; Semados, Bego) were fixed in the reference model. The target variables were: three-dimensional (3D) shift in all directions, implant axis direction, and rotation. The target variables were assessed using a 3D coordinate measuring machine, and the respective deviations of the plaster models from the nominal values of the reference model were calculated. Two different impression techniques (reposition/pickup) and four impression materials (Aquasil Ultra, Flexitime, Impregum Penta, P2 Magnum 360) were investigated. In all, 80 implant impressions for each implant system were taken. Statistical analysis was performed using multivariate analysis of variance. The implant system significantly influenced the transfer accuracy for most spatial dimensions, including the overall 3D shift and implant axis direction. There was no significant difference between the two implant systems with regard to rotation. Multivariate analysis of variance showed a significant effect on transfer accuracy only for the implant system. Within the limits of the present study, it can be concluded that the transfer accuracy of the intraoral implant position on the working cast is far more dependent on the implant system than on the selection of a specific impression technique or material.

  2. [Cost Analysis of Cochlear Implantation in Adults].

    PubMed

    Raths, S; Lenarz, T; Lesinski-Schiedat, A; Flessa, S

    2016-04-01

    The number of implantation of cochlear implants has steadily risen in recent years. Reasons for this are an extension of indication criteria, demographic change, increased quality of life needs and greater acceptance. The consequences are rising expenditure for statutory health insurance (SHI) for cochlear implantation. A detailed calculation of lifetime costs from SHI's perspective for postlingually deafened adolescents and adults is essential in estimating future cost developments. Calculations are based on accounting data from the Hannover Medical School. With regard to further life expectancy, average costs of preoperative diagnosis, surgery, rehabilitation, follow-ups, processor upgrades and electrical maintenance were discounted to their present value at age of implantation. There is an inverse relation between cost of unilateral cochlear implantation and age of initial implantation. From SHI's perspective, the intervention costs between 36,001 and 68,970 € ($ 42,504-$ 81,429). The largest cost components are initial implantation and processor upgrades. Compared to the UK the cost of cochlear implantation in Germany seems to be significantly lower. In particular the costs of, rehabilitation and maintenance in Germany cause only a small percentage of total costs. Also, the costs during the first year of treatment seem comparatively low. With regard to future spending of SHI due to implant innovations and associated extension of indication, increasing cost may be suspected. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Bilayer Implants

    PubMed Central

    Schagemann, Jan C.; Rudert, Nicola; Taylor, Michelle E.; Sim, Sotcheadt; Quenneville, Eric; Garon, Martin; Klinger, Mathias; Buschmann, Michael D.; Mittelstaedt, Hagen

    2016-01-01

    Objective To compare the regenerative capacity of 2 distinct bilayer implants for the restoration of osteochondral defects in a preliminary sheep model. Methods Critical sized osteochondral defects were treated with a novel biomimetic poly-ε-caprolactone (PCL) implant (Treatment No. 2; n = 6) or a combination of Chondro-Gide and Orthoss (Treatment No. 1; n = 6). At 19 months postoperation, repair tissue (n = 5 each) was analyzed for histology and biochemistry. Electromechanical mappings (Arthro-BST) were performed ex vivo. Results Histological scores, electromechanical quantitative parameter values, dsDNA and sGAG contents measured at the repair sites were statistically lower than those obtained from the contralateral surfaces. Electromechanical mappings and higher dsDNA and sGAG/weight levels indicated better regeneration for Treatment No. 1. However, these differences were not significant. For both treatments, Arthro-BST revealed early signs of degeneration of the cartilage surrounding the repair site. The International Cartilage Repair Society II histological scores of the repair tissue were significantly higher for Treatment No. 1 (10.3 ± 0.38 SE) compared to Treatment No. 2 (8.7 ± 0.45 SE). The parameters cell morphology and vascularization scored highest whereas tidemark formation scored the lowest. Conclusion There was cell infiltration and regeneration of bone and cartilage. However, repair was incomplete and fibrocartilaginous. There were no significant differences in the quality of regeneration between the treatments except in some histological scoring categories. The results from Arthro-BST measurements were comparable to traditional invasive/destructive methods of measuring quality of cartilage repair. PMID:27688843

  4. Modeling and Optimization of Direct Chill Casting to Reduce Ingot Cracking

    SciTech Connect

    Das, Subodh K.

    2006-01-09

    A successful four-year project on the modeling and optimization of direct chill (DC) casting to reduce ingot cracking has been completed. The project involved close collaboration among private industries, national laboratories, and universities. During the four-year project, 16 quarterly meetings brought the industrial partners and the research team together for discussion of research results and research direction. The industrial partners provided guidance, facilities, and experience to the research team. The research team went to two industrial plants to measure temperature distributions in commercial 60,000-lb DC casting ingot. The collaborative research resulted in several major accomplishments or findings: (1) Surface cracks were shown to be a result of hot tearing rather than cold cracks, as was thought before this project. These cracks form on the surface of a DC cast ingot just above the impingement point of the secondary cooling water jets. The cracks form along dendrite and grain boundaries, where solute and impurity elements are highly segregated. This understanding led to the development of a new technique for determining the mechanical properties in the nonequilibrium mushy zone of alloys and to thermodynamic predictions of the hot tearing propensity of DC cast ingots. (2) The apparent heat transfer coefficient (HTC) at the ingot surface in the water cooling region during DC casting was determined on the basis of temperature measurements in commercial DC casting ingots and an inverse heat transfer analysis. HTCs were calculated as a function of temperature and time, and covered the different regimes of heat transfer expected during DC casting. The calculated values were extrapolated to include the effect of water flow rate. The calculated HTCs had a peak at around 200 C, corresponding to the high heat transfer rates during nucleate boiling, and the profile was consistent with similar data published in the literature. (3) A new method, termed the

  5. [Penile Flexiflate® Surgitek prosthesis explant and simultaneous three-component hydraulic Titan® Alpha 1 prosthesis implantation, with double incision technique in a patient with kidney and pancreas transplant].

    PubMed

    Pavone, Carlo; Abbadessa, Daniela; Leto, Gioacchino; Giaimo, Rosa Maria; Ascoli, Riccardo; Usala, Manuela; Caruana, Giovanni

    2011-01-01

    We treated a 45 years old patient, suffering from diabetes mellitus since childhood, with retinal, neurovascular and kidney complications. In 1988, for erectile dysfunction (ED) resistant to medical injective treatment, the patient underwent ligation of the dorsal vein of the penis without any result. In 1989 a Flexiflate® hydraulic prosthesis was implanted with resolution of ED. In 2005 the patient underwent simultaneous kidney and pancreas transplant with a trans-laparotomic approach for end stage renal disease and diabetes mellitus. In 2009, because of the Flexiflate® Surgitek malfunction, the patient underwent explantation of the Flexiflate® prosthesis and simultaneous implantation of a Titan® Alpha 1 prosthesis with a double surgical approach. After a peno-scrotal incision and the explant of the Flexiflate® Surgitek, a Titan® Alpha 1 prosthesis was implanted with a double incision technique. The placement of two inflatable cylinders and the pump was performed by peno-scrotal approach. Instead, the prosthesis' reservoir was placed with a separate infra-pubic incision to avoid possible injury from a single trans-inguinal approach, due to the previous laparotomy. After follow-up at 9 months and 1 year the prosthesis was working well and the patient satisfied. We couldn't find any related paper in the literature and as far as we know this is the only report on a simultaneous explant/implant of penile prosthesis with a double surgical approach in a patient with kidney and pancreas transplant.

  6. Digital versus conventional implant impressions for edentulous patients: accuracy outcomes.

    PubMed

    Papaspyridakos, Panos; Gallucci, German O; Chen, Chun-Jung; Hanssen, Stijn; Naert, Ignace; Vandenberghe, Bart

    2016-04-01

    To compare the accuracy of digital and conventional impression techniques for completely edentulous patients and to determine the effect of different variables on the accuracy outcomes. A stone cast of an edentulous mandible with five implants was fabricated to serve as master cast (control) for both implant- and abutment-level impressions. Digital impressions (n = 10) were taken with an intraoral optical scanner (TRIOS, 3shape, Denmark) after connecting polymer scan bodies. For the conventional polyether impressions of the master cast, a splinted and a non-splinted technique were used for implant-level and abutment-level impressions (4 cast groups, n = 10 each). Master casts and conventional impression casts were digitized with an extraoral high-resolution scanner (IScan D103i, Imetric, Courgenay, Switzerland) to obtain digital volumes. Standard tessellation language (STL) datasets from the five groups of digital and conventional impressions were superimposed with the STL dataset from the master cast to assess the 3D (global) deviations. To compare the master cast with digital and conventional impressions at the implant level, analysis of variance (ANOVA) and Scheffe's post hoc test was used, while Wilcoxon's rank-sum test was used for testing the difference between abutment-level conventional impressions. Significant 3D deviations (P < 0.001) were found between Group II (non-splinted, implant level) and control. No significant differences were found between Groups I (splinted, implant level), III (digital, implant level), IV (splinted, abutment level), and V (non-splinted, abutment level) compared with the control. Implant angulation up to 15° did not affect the 3D accuracy of implant impressions (P > 0.001). Digital implant impressions are as accurate as conventional implant impressions. The splinted, implant-level impression technique is more accurate than the non-splinted one for completely edentulous patients, whereas there was no difference in the accuracy

  7. [Bilateral cochlear implantation].

    PubMed

    Kronenberg, Jona; Migirov, Lela; Taitelbaum-Swead, Rikey; Hildesheimer, Minka

    2010-06-01

    Cochlear implant surgery became the standard of care in hearing rehabilitation of patients with severe to profound sensorineural hearing loss. This procedure may alter the lives of children and adults enabling them to integrate with the hearing population. In the past, implantation was performed only in one ear, despite the fact that binaural hearing is superior to unilateral, especially in noisy conditions. Cochlear implantation may be performed sequentially or simultaneously. The "sensitive period" of time between hearing loss and implantation and between the two implantations, when performed sequentially, significantly influences the results. Shorter time spans between implantations improve the hearing results after implantation. Hearing success after implantation is highly dependent on the rehabilitation process which includes mapping, implant adjustments and hearing training. Bilateral cochlear implantation in children is recommended as the proposed procedure in spite of the additional financial burden.

  8. Electrophonic hearing and cochlear implants.

    PubMed

    Risberg, A; Agelfors, E; Lindström, B; Bredberg, G

    1990-01-01

    It has been difficult to explain the good speech understanding obtained by some cochlear implant patients fitted with a single-channel electrode and analog transmissions of the speech signal (Vienna/3M implant). It has also been difficult to explain the variation in results reported by different groups using the same implant. One hypothesis asserts that the above differences can be explained by the observation that electric stimulation with an implanted electrode might result in two different auditory sensations, the first resulting from the stimulation of the remaining hair cells (electrophonic component) and the second from the electric stimulation of the auditory nerve (electro-neural component). The two sensations are very different. As a result of different definitions of total deafness (functional or threshold definition), patients with remaining hair cells are operated on by some groups, but not by other groups. Some published results from different studies are discussed with reference to the above hypothesis and the possible consequences for the selection of the patients, the use of extra- or intracochlear electrodes, and the selection of the speech coding strategy are discussed.

  9. Randomized study on the effect of single-implant versus two-implant retained overdentures on implant loss and muscle activity: a 12-month follow-up report.

    PubMed

    Alqutaibi, A Y; Kaddah, A F; Farouk, M

    2017-02-22

    The objective was to evaluate and compare single- and two-implant retained overdentures for the rehabilitation of the edentulous mandible. Fifty-six edentulous subjects were eligible for inclusion. Using a random sampling system, a single implant or two implants were placed in the mandible. After 3 months, locator attachments were connected to the implants and the denture delivered with the retentive components incorporated in the denture base. Implant failure and muscle activity were evaluated at the 3-, 6-, and 12-month follow-up examinations. The study sample comprised 56 patients (32 male, 24 female), with a mean age of 58.2 years. A total of 84 implants were placed (28 in the single-implant group and 56 in the two-implant group). All patients completed the 12 months of follow-up. No significant differences were found between subjects in the two groups with respect to implant failure. With regard to improvements in muscle activity, the two-implant group showed statistically significant but perhaps not clinically important differences. Single-implant mandibular overdentures may be suggested as an alternative treatment modality for the rehabilitation of edentulous patients who cannot afford the cost of a two-implant overdenture.

  10. Analysis of short implants and lateralization of the inferior alveolar nerve with 2-stage dental implants by finite element method.

    PubMed

    Vasco, Marco Antonio Amorim; Hecke, Mildred Ballin; Bezzon, Osvaldo Luiz

    2011-11-01

    There are difficulties for dental implant use in posterior mandible when there is little bone height for implant placement. Among the treatment alternatives available, there is no direct comparison between short implants and conventional implants placed with lateralization of the inferior alveolar nerve. The present study aimed to comparatively evaluate the risk of peri-implant bone loss of the above treatments. With this aim, computed tomography scans of mandibles were processed, and implants and prosthetic components were reverse engineered for reconstruction of three-dimensional models to simulate the biomechanical behavior of 3-element fixed partial dentures supported by 2 osseointegrated implants, using simulations with the finite element method. The models of implants were based on MK III implants (Nobel Biocare) of 5- and 4-mm diameter by 7-mm length, representing short implants, and 4- and 3.75-mm diameter by 15-mm length, representing implants used in lateralization of the inferior alveolar nerve. All models were simulated with prestress concerning the stresses generated by the torque of the screw. Axial and oblique occlusal loads at 45% were simulated, resulting in 8 different simulations. The results showed that the risk for bone loss in osseointegrated implants is greater for treatments with short implants.

  11. The effect of bruxism on treatment planning for dental implants.

    PubMed

    Misch, Carl E

    2002-09-01

    Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.

  12. Evaluating the Upset Protrusion Joining (UPJ) Method to Join magnesium Castings to Dissimilar Metals

    SciTech Connect

    Logan, Stephen D.

    2015-08-19

    This presentation discusses advantages and best practices for incorporating magnesium in automotive component applications to achieve substantial mass reduction, as well as some of the key challenges with respect to joining, coating, and galvanic corrosion, before providing an introduction and status update of the U.S. Department of Energy and Department of Defense jointly sponsored Upset Protrusion Joining (UPJ) process development and evaluation project. This update includes sharing performance results of a benchmark evaluation of the self-pierce riveting (SPR) process for joining dissimilar magnesium (Mg) to aluminum (Al) materials in four unique coating configurations before introducing the UPJ concept and comparing performance results of the joints made with the UPJ process to those made with the SPR process.

  13. Finite element analysis of thumb carpometacarpal joint implants

    SciTech Connect

    Nielsen, C.

    1995-11-01

    The thumb carpometacarpal joint is frequently replaced in women who have developed severe osteoarthritis of the hand. A new, privately developed implant design consists of two components, trapezial and metacarpal, each with a saddle-shaped articulating surface. A three dimensional finite element model of this implant has been developed to analyze stresses on the device. The first simulations using the model involve loading the implant with forces normal to the trapezial component. Preliminary results show contact stress distributions at the particulating surfaces of the implant.

  14. Norplant implants.

    PubMed

    Henley, E

    1993-06-01

    This letter to the editor is in response to 3 articles on the use of the Norplant implant contraceptive in The Indian Health Service (IHS) Provider. Norplant and the FDA-approved Depo-Provera now expand contraceptive options for women. All IHS and 638 sites might be able to offer both options. Several of the authors expressed concern regarding decreased Norplant effectiveness in heavier patients. Norplant is still more effective than any other currently available reversible contraceptive in the US at all weights. Many experts feel the current silastic capsule provides adequate hormone levels even in heavier women. The Crow Service Unit has initiated their Norplant program, although the Wyeth consent form seems unnecessarily extensive. The Albuquerque Service Unit consent form simply describes the procedure and confirms that patients have read and understand the fact sheet. The theoretical risk of thromboembolism is vastly outweighed by the potential benefit of reliable contraception in high risk alcoholic women, except perhaps in women with severe liver disease. While Norplant is expensive, programs need to consider the actual cost of a pregnancy, potential complications, and the financial and social costs of unintended pregnancy. For those in difficult straits, the manufacturer has set up a foundation for obtaining Norplant free of charge. Depo-Provera comes in a 150 mg dose vial that is given every 3 months. The mean time to ovulation is 4.5 months from the last dose. The adverse reaction spectrum is similar to Norplant as they are both progesterone-related agents. Providers and clinics should reduce barriers to family planning by giving out more pill packs at a time; letting adolescents who wish to delay their first pelvic exam have 3 months of pills without an exam; making condoms available in exam rooms rather than through pharmacy prescriptions; and increasing patient accessibility to the morning-after pill.

  15. Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants.

    PubMed

    Adams, William P; Culbertson, Eric J; Deva, Anand K; R Magnusson, Mark; Layt, Craig; Jewell, Mark L; Mallucci, Patrick; Hedén, Per

    2017-09-01

    Bacteria/biofilm on breast implant surfaces has been implicated in capsular contracture and breast implant-associated anaplastic large-cell lymphoma (ALCL). Macrotextured breast implants have been shown to harbor more bacteria than smooth or microtextured implants. Recent reports also suggest that macrotextured implants are associated with a significantly higher incidence of breast implant-associated ALCL. Using techniques to reduce the number of bacteria around implants, specifically, the 14-point plan, has successfully minimized the occurrence of capsular contracture. The authors hypothesize that a similar effect may be seen in reducing the risk of breast implant-associated ALCL. Pooled data from eight plastic surgeons assessed the use of macrotextured breast implants (Biocell and polyurethane) and known cases of breast implant-associated ALCL. Surgeon adherence to the 14-point plan was also analyzed. A total of 42,035 Biocell implants were placed in 21,650 patients; mean follow-up was 11.7 years (range, 1 to 14 years). A total of 704 polyurethane implants were used, with a mean follow-up of 8.0 years (range, 1 to 20 years). The overall capsular contracture rate was 2.2 percent. There were no cases of implant-associated ALCL. All surgeons routinely performed all 13 perioperative components of the 14-point plan; two surgeons do not routinely prescribe prophylaxis for subsequent unrelated procedures. Mounting evidence implicates the role of a sustained T-cell response to implant bacteria/biofilm in the development of breast implant-associated ALCL. Using the principles of the 14-point plan to minimize bacterial load at the time of surgery, the development and subsequent sequelae of capsular contracture and breast implant-associated ALCL may be reduced, especially with higher-risk macrotextured implants. Therapeutic, IV.

  16. MR Imaging of Knee Arthroplasty Implants

    PubMed Central

    Fritz, Jan; Lurie, Brett

    2015-01-01

    Primary total knee arthroplasty is a highly effective treatment that relieves pain and improves joint function in a large percentage of patients. Despite an initially satisfactory surgical outcome, pain, dysfunction, and implant failure can occur over time. Identifying the etiology of complications is vital for appropriate management and proper timing of revision. Due to the increasing number of knee arthroplasties performed and decreasing patient age at implantation, there is a demand for accurate diagnosis to determine appropriate treatment of symptomatic joints following knee arthroplasty, and for monitoring of patients at risk. Magnetic resonance (MR) imaging allows for comprehensive imaging evaluation of the tissues surrounding knee arthroplasty implants with metallic components, including the polyethylene components. Optimized conventional and advanced pulse sequences can result in substantial metallic artifact reduction and afford improved visualization of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. In this review article, we discuss strategies for MR imaging around knee arthroplasty implants and illustrate the imaging appearances of common modes of failure, including aseptic loosening, polyethylene wear–induced synovitis and osteolysis, periprosthetic joint infections, fracture, patellar clunk syndrome, recurrent hemarthrosis, arthrofibrosis, component malalignment, extensor mechanism injury, and instability. A systematic approach is provided for evaluation of MR imaging of knee implants. MR imaging with optimized conventional pulse sequences and advanced metal artifact reduction techniques can contribute important information for diagnosis, prognosis, risk stratification, and surgical planning. ©RSNA, 2015 PMID:26295591

  17. Implantable, multifunctional, bioresorbable optics

    PubMed Central

    Tao, Hu; Kainerstorfer, Jana M.; Siebert, Sean M.; Pritchard, Eleanor M.; Sassaroli, Angelo; Panilaitis, Bruce J. B.; Brenckle, Mark A.; Amsden, Jason J.; Levitt, Jonathan; Fantini, Sergio; Kaplan, David L.; Omenetto, Fiorenzo G.

    2012-01-01

    Advances in personalized medicine are symbiotic with the development of novel technologies for biomedical devices. We present an approach that combines enhanced imaging of malignancies, therapeutics, and feedback about therapeutics in a single implantable, biocompatible, and resorbable device. This confluence of form and function is accomplished by capitalizing on the unique properties of silk proteins as a mechanically robust, biocompatible, optically clear biomaterial matrix that can house, stabilize, and retain the function of therapeutic components. By developing a form of high-quality microstructured optical elements, improved imaging of malignancies and of treatment monitoring can be achieved. The results demonstrate a unique family of devices for in vitro and in vivo use that provide functional biomaterials with built-in optical signal and contrast enhancement, demonstrated here with simultaneous drug delivery and feedback about drug delivery with no adverse biological effects, all while slowly degrading to regenerate native tissue. PMID:23150544

  18. Clinical evaluation of mandibular implant overdentures via Locator implant attachment and Locator bar attachment.

    PubMed

    Seo, Yong-Ho; Bae, Eun-Bin; Kim, Jung-Woo; Lee, So-Hyoun; Yun, Mi-Jung; Jeong, Chang-Mo; Jeon, Young-Chan; Huh, Jung-Bo

    2016-08-01

    The aim of this study was to evaluate the clinical findings and patient satisfaction on implant overdenture designed with Locator implant attachment or Locator bar attachment in mandibular edentulous patients. Implant survival rate, marginal bone loss, probing depth, peri-implant inflammation, bleeding, plaque, calculus, complications, and satisfaction were evaluated on sixteen patients who were treated with mandibular overdenture and have used it for at least 1 year (Locator implant attachment: n=8, Locator bar attachment: n=8). Marginal bone loss, probing depth, plaque index of the Locator bar attachment group were significantly lower than the Locator implant attachment group (P<.05). There was no significant difference on bleeding, peri-implant inflammation, and patient satisfaction between the two denture types (P>.05). The replacement of the attachment components was the most common complication in both groups. Although there was no correlation between marginal bone loss and plaque index, a significant correlation was found between marginal bone loss and probing depth. The Locator bar attachment group indicates lesser marginal bone loss and need for maintenance, as compared with the Locator implant attachment group. This may be due to the splinting effect among implants rather than the types of Locator attachment.

  19. Clinical evaluation of mandibular implant overdentures via Locator implant attachment and Locator bar attachment

    PubMed Central

    Seo, Yong-Ho; Bae, Eun-Bin; Kim, Jung-Woo; Lee, So-Hyoun; Jeong, Chang-Mo; Jeon, Young-Chan

    2016-01-01

    PURPOSE The aim of this study was to evaluate the clinical findings and patient satisfaction on implant overdenture designed with Locator implant attachment or Locator bar attachment in mandibular edentulous patients. MATERIALS AND METHODS Implant survival rate, marginal bone loss, probing depth, peri-implant inflammation, bleeding, plaque, calculus, complications, and satisfaction were evaluated on sixteen patients who were treated with mandibular overdenture and have used it for at least 1 year (Locator implant attachment: n=8, Locator bar attachment: n=8). RESULTS Marginal bone loss, probing depth, plaque index of the Locator bar attachment group were significantly lower than the Locator implant attachment group (P<.05). There was no significant difference on bleeding, peri-implant inflammation, and patient satisfaction between the two denture types (P>.05). The replacement of the attachment components was the most common complication in both groups. Although there was no correlation between marginal bone loss and plaque index, a significant correlation was found between marginal bone loss and probing depth. CONCLUSION The Locator bar attachment group indicates lesser marginal bone loss and need for maintenance, as compared with the Locator implant attachment group. This may be due to the splinting effect among implants rather than the types of Locator attachment. PMID:27555901

  20. Do "premium" joint implants add value?: analysis of high cost joint implants in a community registry.

    PubMed

    Gioe, Terence J; Sharma, Amit; Tatman, Penny; Mehle, Susan

    2011-01-01

    Numerous joint implant options of varying cost are available to the surgeon, but it is unclear whether more costly implants add value in terms of function or longevity. We evaluated registry survival of higher-cost "premium" knee and hip components compared to lower-priced standard components. Premium TKA components were defined as mobile-bearing designs, high-flexion designs, oxidized-zirconium designs, those including moderately crosslinked polyethylene inserts, or some combination. Premium THAs included ceramic-on-ceramic, metal-on-metal, and ceramic-on-highly crosslinked polyethylene designs. We compared 3462 standard TKAs to 2806 premium TKAs and 868 standard THAs to 1311 premium THAs using standard statistical methods. The cost of the premium implants was on average approximately $1000 higher than the standard implants. There was no difference in the cumulative revision rate at 7-8 years between premium and standard TKAs or THAs. In this time frame, premium implants did not demonstrate better survival than standard implants. Revision indications for TKA did not differ, and infection and instability remained contributors. Longer followup is necessary to demonstrate whether premium implants add value in younger patient groups. Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  1. Burnishing Techniques Strengthen Hip Implants

    NASA Technical Reports Server (NTRS)

    2010-01-01

    In the late 1990s, Lambda Research Inc., of Cincinnati, Ohio, received Small Business Innovation Research (SBIR) awards from Glenn Research Center to demonstrate low plasticity burnishing (LPB) on metal engine components. By producing a thermally stable deep layer of compressive residual stress, LPB significantly strengthened turbine alloys. After Lambda patented the process, the Federal Aviation Administration accepted LPB for repair and alteration of commercial aircraft components, the U.S. Department of Energy found LPB suitable for treating nuclear waste containers at Yucca Mountain. Data from the U.S. Food and Drug Administration confirmed LPB to completely eliminate the occurrence of fretting fatigue failures in modular hip implants.

  2. Peri-Implant Diseases

    MedlinePlus

    ... Alcohol Consumption and Gum Health Workshop on Regeneration Periodontal Disease More Prevalent among Ethnic Minorities Dental Implants Periodontal ... factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking , and diabetes . It ...

  3. Implants for lucky few

    NASA Astrophysics Data System (ADS)

    Brandon, David

    2011-08-01

    In his article "Vision of beauty" (May pp22-27), Richard Taylor points the way to fractal design for retinal implants and makes an enthusiastic case for incorporating such features into the next generation of such implants.

  4. Evaluating the Upset Protrusion Joining (UPJ) Method to Join Magnesium Castings to Dissimilar Metals

    SciTech Connect

    Logan, Stephen

    2016-02-24

    This presentation discusses advantages and best practices for incorporating magnesium in automotive component applications to achieve substantial mass reduction, as well as some of the key challenges with respect to joining, coating, and galvanic corrosion, before providing an introduction and status update of the U.S. Department of Energy and Department of Defense jointly sponsored Upset Protrusion Joining (UPJ) process development and evaluation project. This update includes sharing performance results of a benchmark evaluation of the self-pierce riveting (SPR) process for joining dissimilar magnesium (Mg) to aluminum (Al) materials in four unique coating configurations before introducing the UPJ concept and comparing performance results of the joints made with the UPJ process to those made with the SPR process. Key results presented include: • The benchmark SPR process can produce good joints in the MgAM60B-Al 6013 joint configuration with minimal cracking in the Mg coupons if the rivet is inserted from the Mg side into the Al side. • Numerous bare Mg to bare Al joints made with the SPR process separated after only 6-wks of accelerated corrosion testing due to fracture of the rivet as a result of hydrogen embrittlement • For the same joint configurations, UPJ demonstrated substantially higher pre-corrosion joint strengths and post-corrosion joint strengths, primarily because of the larger diameter protrusion compared to smaller SPR rivet diameter and reduced degradation due to accelerated corrosion exposure • As with the SPR process, numerous bare Mg to bare Al joints made with the UPJ process also separated after 6-wks of accelerated corrosion testing, but unlike the SPR experience, the UPJ joints experienced degradation of the boss and head because of galvanic corrosion of the Mg casting, not hydrogen embrittlement of the steel rivet. • In the configuration where both the Mg and Al were pretreated with Alodine 5200 prior to joining and the complete

  5. Effect of smoking on the survival of dental implants.

    PubMed

    Takamiya, Aline Satie; Goiato, Marcelo Coelho; Gennari Filho, Humberto

    2014-12-01

    Although the long-term success of implant treatment has been well- established, failures can still occur and the smoking habit has been reported as a risk factor for implant loss. A literature review on the effects of smoking on the survival of dental implants was undertaken. Medline database was used to carry out the review with the keywords "osseointegration", "smoking" and "bone healing". The cigarette has more than 4,000 bioactive chemical components with potential toxic effects to human tissues including bone. Nicotine is the main component of the cigarette and it is frequently associated with bone healing failures. Since smoking negatively affects the osseointegration of dental implants, the main target is to quit the consumption of cigarettes. Nevertheless, the smoking habit should not be an absolute contraindication for implant treatment, but, patients should be advised that they are at a greater risk of implant failure.

  6. Wearable and implantable pancreas substitutes.

    PubMed

    Ricotti, Leonardo; Assaf, Tareq; Dario, Paolo; Menciassi, Arianna

    2013-03-01

    A lifelong-implanted and completely automated artificial or bioartificial pancreas (BAP) is the holy grail for type 1 diabetes treatment, and could be a definitive solution even for other severe pathologies, such as pancreatitis and pancreas cancer. Technology has made several important steps forward in the last years, providing new hope for the realization of such devices, whose feasibility is strictly connected to advances in glucose sensor technology, subcutaneous and intraperitoneal insulin pump development, the design of closed-loop control algorithms for mechatronic pancreases, as well as cell and tissue engineering and cell encapsulation for biohybrid pancreases. Furthermore, smart integration of the mentioned components and biocompatibility issues must be addressed, bearing in mind that, for mechatronic pancreases, it is most important to consider how to recharge implanted batteries and refill implanted insulin reservoirs without requiring periodic surgical interventions. This review describes recent advancements in technologies and concepts related to artificial and bioartificial pancreases, and assesses how far we are from a lifelong-implanted and self-working pancreas substitute that can fully restore the quality of life of a diabetic (or other type of) patient.

  7. Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hasenstab, M. Suzanne; Laughton, Joan

    1991-01-01

    The use of cochlear implants in children with profound bilateral hearing loss is discussed, focusing on how a cochlear implant works; steps in a cochlear implant program (evaluation, surgery, programing, and training); and rehabilitation procedures involved in auditory development and speech development. (JDD)

  8. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  9. Modified titanium implant as a gateway to the human body: the implant mediated drug delivery system.

    PubMed

    Park, Young-Seok; Cho, Joo-Youn; Lee, Shin-Jae; Hwang, Chee Il

    2014-01-01

    The aim of this study was to investigate the efficacy of a proposed new implant mediated drug delivery system (IMDDS) in rabbits. The drug delivery system is applied through a modified titanium implant that is configured to be implanted into bone. The implant is hollow and has multiple microholes that can continuously deliver therapeutic agents into the systematic body. To examine the efficacy and feasibility of the IMDDS, we investigated the pharmacokinetic behavior of dexamethasone in plasma after a single dose was delivered via the modified implant placed in the rabbit tibia. After measuring the plasma concentration, the areas under the curve showed that the IMDDS provided a sustained release for a relatively long period. The result suggests that the IMDDS can deliver a sustained release of certain drug components with a high bioavailability. Accordingly, the IMDDS may provide the basis for a novel approach to treating patients with chronic diseases.

  10. Tibial plateau coverage in UKA: a comparison of patient specific and off-the-shelf implants.

    PubMed

    Carpenter, Dylan P; Holmberg, Rebecca R; Quartulli, Marc J; Barnes, C Lowry

    2014-09-01

    Poor tibial component fit can lead to issues including pain, loosening and subsidence. Morphometric data, from 30 patients undergoing UKA were utilized; comparing size, match and fit between patient-specific and off-the-shelf implants. CT images were prospectively obtained and implants modeled in CAD, utilizing sizing templates with off-the-shelf and CAD designs with patient-specific implants. Virtual surgery was performed, maximizing tibial plateau coverage while minimizing implant overhang. Each implant evaluated to examine tibial fit. Patient-specific implants provided significantly greater cortical rim surface area coverage versus off-the-shelf implants: 77% v. 43% medially and 60% v. 37% laterally. Significantly less cortical rim overhang and undercoverage were observed with patient-specific implants. Patient-specific implants provide superior cortical bone coverage and fit while minimizing overhang and undercoverage seen in off-the-shelf implants. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Material considerations for intervertebral disc replacement implants.

    PubMed

    Taksali, Sudeep; Grauer, Jonathan N; Vaccaro, Alexander R

    2004-01-01

    Cervical and lumbar disc replacements are being performed with increasing frequency. Much of the background for the development for these implants is drawn from the literature of other joint replacements that have been in evolution and use for decades. Important variables for the function and longevity of such disc arthroplasty implants are clearly defined by the material properties of the components used for their production. The most frequently considered materials are cobalt-chrome alloys, titanium alloys, stainless steels, polyethylene, polyurethane and ceramics. In addition to implant materials, the interfaces of such materials must be considered. The bearing surfaces of an implant, in particular, are at risk of wear and failure. Overall, successful, long-term total disc arthroplasty requires a thorough understanding of biomaterials and how they can be used to achieve their desired goals.

  12. Trends in Cochlear Implants

    PubMed Central

    Zeng, Fan-Gang

    2004-01-01

    More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

  13. Tapered Implants in Dentistry: Revitalizing Concepts with Technology: A Review.

    PubMed

    Wilson, T G; Miller, R J; Trushkowsky, R; Dard, M

    2016-03-01

    The most common approach to lessen treatment times is by decreasing the healing period during which osseointegration is established. Implant design parameters such as implant surface, primary stability, thread configuration, body shape, and the type of bone have to be considered to obtain this objective. The relationship that exists between these components will define the initial stability of the implant. It is believed implant sites using a tapered design and surface modification can increase the primary stability in low-density bone. Furthermore, recent experimental preclinical work has shown the possibility of attaining primary stability of immediately loaded, tapered dental implants without compromising healing and rapid bone formation while minimizing the implant stability loss at compression sites. This may be of singular importance with immediate/early functional loading of single implants placed in poor-quality bone. The selection of an implant that will provide adequate stability in bone of poor quality is important. A tapered-screw implant design will provide adequate stability because it creates pressure on cortical bone in areas of reduced bone quality. Building on the success of traditional tapered implant therapy, newer tapered implant designs should aim to maximize the clinical outcome by implementing new technologies with adapted clinical workflows. © International & American Associations for Dental Research 2016.

  14. Reliability systems for implantable cardiac defibrillator batteries

    NASA Astrophysics Data System (ADS)

    Takeuchi, Esther S.

    The reliability of the power sources used in implantable cardiac defibrillators is critical due to the life-saving nature of the device. Achieving a high reliability power source depends on several systems functioning together. Appropriate cell design is the first step in assuring a reliable product. Qualification of critical components and of the cells using those components is done prior to their designation as implantable grade. Product consistency is assured by control of manufacturing practices and verified by sampling plans using both accelerated and real-time testing. Results to date show that lithium/silver vanadium oxide cells used for implantable cardiac defibrillators have a calculated maximum random failure rate of 0.005% per test month.

  15. Rigid connections between natural teeth and implants: a technical note.

    PubMed

    Lindh, T; Gunne, J; Danielsson, S

    1997-01-01

    In the posterior partially edentulous jaw, implants may be used to supplement existing natural dentition. Frequently, the maxillary sinuses and the mandibular nerve preclude the fabrication of freestanding implant-retained prostheses. However, if an implant and a natural abutment are combined, a fixed prosthesis can be fabricated, restoring the arch into the premolar area. The histories of three patients with attachments connecting implant-retained ceramotitanium crowns with crowns on natural abutments are described. A design for a rigid custom-made attachment for the Brånemark system, using standard components with a machine-duplication, spark-erosion technique, is suggested.

  16. Percutaneous Implants with Porous Titanium Dermal Barriers: An In Vivo Evaluation of Infection Risk

    PubMed Central

    Isackson, Dorthyann; McGill, Lawrence D.; Bachus, Kent N.

    2010-01-01

    Osseointegrated percutaneous implants are a promising prosthetic alternative for a subset of amputees. However, as with all percutaneous implants, they have an increased risk of infection since they breach the skin barrier. Theoretically, host tissues could attach to the metal implant creating a barrier to infection. When compared with smooth surfaces, it is hypothesized that porous surfaces improve the attachment of the host tissues to the implant, and decrease the infection risk. In this study, 4 titanium implants, manufactured with a percutaneous post and a subcutaneous disk, were placed subcutaneously on the dorsum of eight New Zealand White rabbits. Beginning at four weeks post-op, the implants were inoculated weekly with 108 CFU Staphylococcus aureus until signs of clinical infection presented. While we were unable to detect a difference in the incidence of infection of the porous metal implants, smooth surface (no porous coating) percutaneous and subcutaneous components had a 7-fold increased risk of infection compared to the implants with a porous coating on one or both components. The porous coated implants displayed excellent tissue ingrowth into the porous structures; whereas, the smooth implants were surrounded with a thick, organized fibrotic capsule that was separated from the implant surface. This study suggests that porous coated metal percutaneous implants are at a significantly lower risk of infection when compared to smooth metal implants. The smooth surface percutaneous implants were inadequate in allowing a long-term seal to develop with the soft tissue, thus increasing vulnerability to the migration of infecting microorganisms. PMID:21145778

  17. Biofilm on dental implants: a review of the literature.

    PubMed

    Subramani, Karthikeyan; Jung, Ronald E; Molenberg, Aart; Hammerle, Christoph H F

    2009-01-01

    The aim of this article was to review the current literature with regard to biofilm formation on dental implants and the influence of surface characteristics (chemistry, surface free energy, and roughness) of dental implant and abutment materials and their design features on biofilm formation and its sequelae. An electronic MEDLINE literature search was conducted of studies published between 1966 and June 2007. The following search terms were used: biofilm and dental implants, biofilm formation/plaque bacterial adhesion and implants, plaque/biofilm and surface characteristics/roughness/surface free energy of titanium dental implants, implant-abutment interface and plaque/biofilm, biofilm and supragingival/subgingival plaque microbiology, biofilm/plaque and implant infection, antibacterial/bacteriostatic titanium, titanium nanocoating/nanopatterning, antimicrobial drug/titanium implant. Both in vitro and in vivo studies were included in this review. Fifty-three articles were identified in this review process. The articles were categorized with respect to their context on biofilm formation on teeth and dental implant surfaces and with regard to the influence of surface characteristics of implant biomaterials (especially titanium) and design features of implant and abutment components on biofilm formation. The current state of literature is more descriptive, rather than providing strong data that could be analyzed through meta-analysis. Basic research articles on surface modification of titanium were also included in the review to analyze the applications of such studies on the fabrication of implant surfaces that could possibly decrease early bacterial colonization and biofilm formation. Increase in surface roughness and surface free energy facilitates biofilm formation on dental implant and abutment surfaces, although this conclusion is derived from largely descriptive literature. Surface chemistry and the design features of the implant-abutment configuration also

  18. Programming, Care, and Troubleshooting of Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hedley-Williams, Andrea J.; Sladen, Douglas P.; Tharpe, Anne Marie

    2003-01-01

    This article provides an overview of current cochlear implant technology, programming strategies, troubleshooting, and care techniques. It considers: device components, initial stimulation, speech coding strategies, use and care, troubleshooting, and the classroom environment. (Contains references.) (DB)

  19. Effect of anabolic implants on adrenal cortisol synthesis in feedlot beef cattle implanted early or late in the finishing phase.

    PubMed

    Gifford, C A; Branham, K A; Ellison, J O; Gómez, B I; Lemley, C O; Hart, C G; Krehbiel, C R; Bernhard, B C; Maxwell, C L; Goad, C L; Hallford, D M; Hernandez Gifford, J A

    2015-01-01

    Implantation of anabolic steroids to increase growth rate in beef cattle impacts adrenal glucocorticoid production. The mechanism by which combination androgen and estrogen implants reduce cortisol biosynthesis in heifers is not clear. The objective of this study was to identify whether pituitary or adrenal gene expression and liver enzyme activity may contribute to altered serum cortisol concentrations in heifers receiving a combination implant. On d 0 of a 122-d finishing phase, 187 predominantly Angus heifers (361 kg) approximately 14 months old were randomly assigned to one of three implant groups: (1) non-implanted control, (2) implanted at the beginning of the finishing phase (d 0; early implant) with a combination implant (200mg TBA+20mg E2; Revalor 200®), and (3) implanted during the late stage of the finishing phase (d 56; late implant) with Revalor 200®. At d 56, body weight (BW) was greater (P<0.0001) for the early implanted heifers (456 ± 1.9 kg) compared to 437 and 435 (± 1.8) kg for control and late implanted heifers, respectively. Final BW (d 122) was similar between both implanted groups and heavier than non-implanted controls (P<0.0001). Serum cortisol was similar among groups at d 0 (P=0.86) however, by d 28 heifers receiving the combination implant had reduced (P<0.05) serum cortisol concentrations (31.2 ng/mL) compared to controls (49.4 ng/mL) and late (48.2 ng/mL) groups. On d 84 cortisol was similar (P=0.75) among implanted heifers and was less (P<0.01) than non-implanted heifers. Expression of pituitary and adrenal genes involved in glucocorticoid synthesis was evaluated at d 28/29 or 84/85; however, despite decreased serum cortisol in implanted heifers, no change in mRNA expression was demonstrated. Liver CYP3A enzyme activity at d 28/29 was decreased 59% in early implanted heifers compared to control heifers (P=0.01). Additionally, at d 84/85 AKR1C activity was greatest (P=0.01) in control heifers compared to both implanted groups. Data

  20. Music Perception of Cochlear Implant Recipients with Implications for Music Instruction: A Review of Literature.

    PubMed

    Hsiao, Feilin; Gfeller, Kate

    2012-03-23

    This review of literature presents a systematic analysis of the capabilities and limitations of cochlear implant recipients regarding music perception. Specifically, it a) analyzes individual components of music (e.g., rhythm, timbre, and pitch) as they interface with the technical characteristics of cochlear implants and the perceptual abilities of cochlear implant recipients; and b) describes accommodations for music instruction that support successful participation of children with cochlear implants. This article consolidates research studies from various disciplines (audiology, hearing science, speech-language pathology, cochlear implants, and music therapy) to provide practical recommendations for educators in fostering the musical growth of children with cochlear implants.

  1. [Cochlear implant in adults].

    PubMed

    Bouccara, D; Mosnier, I; Bernardeschi, D; Ferrary, E; Sterkers, O

    2012-03-01

    Cochlear implant in adults is a procedure, dedicated to rehabilitate severe to profound hearing loss. Because of technological progresses and their applications for signal strategies, new devices can improve hearing, even in noise conditions. Binaural stimulation, cochlear implant and hearing aid or bilateral cochlear implants are the best opportunities to access to better level of comprehension in all conditions and space localisation. By now minimally invasive surgery is possible to preserve residual hearing and use a double stimulation modality for the same ear: electrical for high frequencies and acoustic for low frequencies. In several conditions, cochlear implant is not possible due to cochlear nerve tumour or major malformations of the inner ear. In these cases, a brainstem implantation can be considered. Clinical data demonstrate that improvement in daily communication, for both cochlear and brainstem implants, is correlated with cerebral activation of auditory cortex.

  2. Osteointegration of a modular metal-polyethylene surface gliding finger implant: a case report.

    PubMed

    Schindele, Stephan F; Sprecher, Christoph M; Milz, Stefan; Hensler, Stefanie

    2016-09-01

    Primary press fit and secondary osteointegration is a precondition for component anchoring in articular surface replacements, also in the case of proximal interphalangeal (PIP) joint. Nevertheless, many existing prostheses for the PIP joint have failed to show sufficient osteointegration. CapFlex-PIP(©) implant is a modular metal-polyethylene surface replacement for the PIP joint consisting of a proximal and distal component each having a titanium pore backside, which allows secondary osteointegration at the bone-implant interface. To evaluate osseous integration of this implant, we report a histological analysis of an explantation of a CapFlex-PIP(©) finger implant. We present a case of a removed CapFlex-PIP(©) implant due to a soft tissue complication in an 84-year-old woman. The patient received bisphosphonate medication as treatment for osteoporosis. For the histological analysis, the bone-implant contact (BIC) was measured on all stained sections using a Zeiss Axioplan microscope. The summated BIC was 40.7 % for the proximal component and 46.5 % for the distal component of the implant. Histology showed that the implant was in direct contact with the bone at various locations, with no signs of wear or degradation. This case demonstrates successful osteointegration of the CapFlex-PIP(©) implant. Both components of the investigated implant show osseous integration to an extent which is comparable to that of other load-bearing and articulating implants at different locations in the human body.

  3. Diclofenac Sodium Loaded Multicomponent Implant

    NASA Astrophysics Data System (ADS)

    Nikkola, Lila; Viitanen, Petrus; Ashammakhi, Nureddin

    2008-02-01

    Earlier we have reported on developing DS releasing bioabsorbable rods for inhibition of osteolysis [l]. Due to their unsatisfactory drug release profiles we assessed the use of sintering technique of enhancement of drug release in the current study. Melt extruded PLGA 80/20 rods were compounded 8 wt-% DS. Some rods were self reinforced (SR) and some of them were sterilized to get three different components with different drug release profiles. Different rods were sintered together with heat and pressure. Three different specimen groups with different construction were studied. Thermal properties were analyzed using differential scanning calorimetry (DSC). Changes of IV were performed with capillary analysis and drug release measurements with UV-Vis spectrophotometer. Mechanical strength were measured two weeks, when disintegration occurred. Release rate consisted of 1) sharp jump start peak, 2) second smoother peak, and 3) third smooth peak. Released DS concentrations reached local therapeutic levels and maintained at that stage for 24-36 days. All DS was released during 50-70 days. The drug release from multicomponent implant was more stable and commenced earlier than from initial rods. Such properties were favored ones. Initial shear strength was 82 MPa and it decreased to 15 MPa. The mechanical bonding was sufficient although the components disintegrated relatively fast. By sintering different PLGA/DS components with different release rates it is possible to construct a truly controlled release implant for bone fixation with anti-inflammatory properties.

  4. Implant treatment planning considerations.

    PubMed

    Kao, Richard T

    2008-04-01

    As dental implants become a more accepted treatment modality, there is a need for all parties involved with implant dentistry to be familiar with various treatment planning issues. Though the success can be highly rewarding, failure to forecast treatment planning issues can result in an increase of surgical needs, surgical cost, and even case failure. In this issue, the focus is on implant treatment planning considerations.

  5. Teaching implant dentistry in the predoctoral curriculum: a report from the ADEA Implant Workshop's survey of deans.

    PubMed

    Petropoulos, Vicki C; Arbree, Nancy S; Tarnow, Dennis; Rethman, Michael; Malmquist, Jay; Valachovic, Richard; Brunson, W David; Alfano, Michael C

    2006-05-01

    In 2004, a survey of the deans of U.S. and Canadian dental schools was conducted to determine the implant dentistry curriculum structure and the extent of incorporating implant dentistry clinical treatment into predoctoral programs. The questionnaire was mailed to the deans of the fifty-six dental schools in advance of the ADEA Implant Workshop conference held in Arizona in November 2004. Out of the fifty-six, thirty-nine responded, yielding a response rate of 70 percent. Thirty-eight schools (97 percent) reported that their students received didactic instruction in dental implants, while one school (3 percent) said that its students did not. Thirty schools (86 percent) reported that their students received clinical experience, while five schools (14 percent) reported that theirs did not. Four schools (10 percent) did not respond to this question. Fifty-one percent of the students actually receive the clinical experience in restoring implants, with the range of 5-100 percent. Of those schools that provide clinical experience in restoring implants, four schools (13 percent) reported that it is a requirement for them, while twenty-eight schools (88 percent) reported that it is not a requirement for them. Three schools (9 percent) did not respond. The fee for implants is 45 percent higher than a crown or a denture, with a range of 0-100 percent. Twenty-nine schools (85 percent) indicated that they did receive free components from implant companies, while five schools (15 percent) did not. The conclusions of this report are as follows: 1) most schools have advanced dental education programs; 2) single-tooth implant restorations are performed at the predoctoral level in most schools; 3) implant-retained overdenture prostheses are performed at the predoctoral level in most schools; 4) there is no predoctoral clinical competency requirement for surgical implant placement in all schools that responded to the survey; 5) there is no predoctoral clinical competency

  6. Osseointegrated implant prosthodontics.

    PubMed

    Rogoff, G S

    1992-06-01

    This review covers recent literature on prosthodontic aspects of osseointegrated implants. Long-term prognosis, diagnosis and treatment planning, and clinical impression techniques and fabrication technology are discussed.

  7. Angiogenesis after sintered bone implantation in rat parietal bone.

    PubMed

    Ohtsubo, S; Matsuda, M; Takekawa, M

    2003-01-01

    We studied the effect of bone substitutes on revascularization and the restart of blood supply after sintered bone implantation in comparison with synthetic hydroxyapatite implantation and fresh autogenous bone transplantation (control) in rat parietal bones. Methods for the study included the microvascular corrosion cast method and immunohistochemical techniques were also used. The revascularization of the control group was the same as that for usual wound healing in the observations of the microvascular corrosion casts. The sintered bone implantation group was quite similar to that of the control group. In the synthetic hydroxyapatite group, immature newly-formed blood vessels existed even on the 21st day after implantation and the physiological process of angiogenesis was interrupted. Immunohistochemically, vascular endothelial growth factor (VEGF), which activates angiogenesis, appeared at the early stages of both the control group and the sintered bone implantation group. VEGF reduced parallel with the appearance of the transforming growth factor factor-beta-1 (TGF-beta-1), which obstructs angiogenesis, and the angiogenesis passed gradually into the mature stage. In the hydroxyapatite implantation group, TGF-beta-1 appeared at the early stage of the implants. The appearance of VEGF lagged and it existed around the pores of hydroxyapatite even on the 21st day of the implantation. Proliferation and wandering of endothelial cells continued without any maturing of the vessels. These findings suggest that the structure and the components of the implant material affect angiogenesis after implantation as well as new bone formation.

  8. Basic research methods and current trends of dental implant surfaces.

    PubMed

    Coelho, Paulo G; Granjeiro, José M; Romanos, George E; Suzuki, Marcelo; Silva, Nelson R F; Cardaropoli, Giuseppe; Thompson, Van P; Lemons, Jack E

    2009-02-01

    Among dental implant design alterations, surface modifications have been by far the most investigated topic. Regarding implant surface research, the lack of hierarchical approaches relating in vitro, in vivo, clinical trials, and ex vivo analyses has hindered biomaterials scientists with clear informed rationale guidelines for implant surface design. This manuscript provides a critical hierarchical overview of the in vitro, laboratory in vivo, clinical, and ex vivo methodologies used to investigate the performance of novel biomaterials aiming to allow dental professionals to better evaluate the past, present, and future dental implant surface research. This manuscript also contains an overview of the commercially available surface texture and chemistry modifications including novel nanotechnology-based fabrication processes. Over the last decade, surface texturing has been the most utilized parameter for increasing the host-to-implant response. Recently, dental implant surfaces utilizing reduced length scale physico/chemical features (atomic and nanometric) have shown the potential to synergistically use both texture and the inclusion of bioactive ceramic components on the surface. Although surface modifications have been shown to enhance osseointegration at early implantation times, information concerning its long-term benefit to peri-implant tissues is lacking due to the reduced number of controlled clinical trials. Given the various implants/surfaces under study, the clinician should ask, founded on the basic hierarchical approach described for the in vitro, laboratory in vivo data, as well as the results of clinical studies to effectiveness before use of any dental implant.

  9. Gold granuloma after accidental implantation.

    PubMed Central

    Scott, F R; Dhillon, A P; Lewin, J F; Flavell, W; Laws, I M

    1995-01-01

    A case, in a 66 year old man, of a florid granulomatous reaction to gold dental alloy presenting about 20 years after accidental implantation in the oral mucosa of the lip is reported. Subsequent energy dispersive analysis confirmed the presence of a high nobility gold dental alloy. Florid granulomatosis has only rarely been reported in association with gold. Possible explanations for the delay in presentation include alteration of immune status or the development of hypersensitivity with components of the gold dental alloy acting as haptens. Images PMID:8543638

  10. Adaptation of NASA technology for the optimum design of orthopedic knee implants.

    PubMed

    Saravanos, D A; Mraz, P J; Davy, D T; Hopkins, D A

    1991-03-01

    NASA technology originally developed for designing aircraft turbine-engine blades has been adapted and applied to orthopedic knee implants. This article describes a method for tailoring an implant for optimal interaction with the environment of the tibia. The implant components are designed to control stresses in the bone for minimizing bone degradation and preventing failures. Engineers expect the tailoring system to improve knee prosthesis design and allow customized implants for individual patients.

  11. A tag and trace approach to assess the potential contribution of earthworm casts to soil erosion on hillslopes under permanent pasture

    NASA Astrophysics Data System (ADS)

    Greenwood, Philip; Walling, Desmond; Quine, Timothy

    2015-04-01

    This communication presents preliminary results from a tag and trace experiment to assess the potential contribution of earthworm casts to soil erosion on a gentle (i.e. 4%) hillslope under permanent pasture using artificial radionuclides, caesium-134 (134Cs) and cobalt-60 (60Co). A rapid and repeatable laboratory-based procedure was devised for tagging groups of intact, air-dried casts by immersion into solutions containing a known activity concentration of either 134Cs or 60Co, each mixed in 2 l of water. For the tracing component of the work, fifteen intact casts representing the equivalent of 203 g of sediment were labelled with 216 Bq of 134Cs activity and evenly distributed across the upslope half of a 0.6 m long * 0.5 m wide bounded area of pasture, at a distance of ≥ 0.3 m from a plot outlet. A further fifteen intact casts representing the equivalent of 190.7 g of sediment were labelled with 224 Bq of 60Co activity and evenly distributed across the downslope half of the plot, at a distance of ≤ 0.3 m from the plot outlet. Over the following 76 days, all casts were exposed to natural weather events, during which time, 186.3 mm of rainfall generated 16 separate storm runoff samples. Sediment was recovered from the runoff, assayed by gamma spectrometry and a simple mixing model was used to partition the sediment into labelled material and unlabelled surface material. Provisional results indicate that a total of 26.8 g of 60Co-labelled sediment, equivalent to 14.1% of the total mass deployed, was recovered from a distance of ≤ 0.3 m from their original position. In contrast, 9.1 g of 134Cs-labelled sediment, equivalent to 4.5% of the total mass deployed, was recovered from a distance of ≥ 0.3 m from their original position. This presentation discusses key findings, with a particular focus on the temporal changes in sediment-supply, as well as a number of uncertainties associated with the technique. Despite these uncertainties, however, the essentially

  12. Multicomponent Implant Releasing Dexamethasone

    NASA Astrophysics Data System (ADS)

    Nikkola, L.; Vapalahti, K.; Ashammakhi, N.

    2008-02-01

    Several inflammatory conditions are usually treated with corticosteroids. There are various problems like side effects with traditional applications of steroids, e.g. topical, or systemic routes. Local drug delivery systems have been studied and developed to gain more efficient administration with fewer side effects. Earlier, we reported on developing Dexamethasone (DX) releasing biodegradable fibers. However, their drug release properties were not satisfactory in terms of onset of drug release. Thus, we assessed the development of multicomponent (MC) implant to enhance earlier drug release from such biodegradable fibers. Poly (lactide-co-glycolide) (PLGA) and 2 wt-% and 8 wt-% DX were compounded and extruded with twin-screw extruder to form of fibers. Some of the fibers were sterilized to obtain a change in drug release properties. Four different fiber classes were studied: 2 wt-%, 8 wt-%, sterilized 2 wt-%, and sterilized 8 wt-%. 3×4 different DX-releasing fibers were then heat-pressed to form one multicomponent rod. Half of the rods where sterilized. Drug release was measured from initial fibers and multicomponent rods using a UV/VIS spectrometer. Shear strength and changes in viscosity were also measured. Drug release studies showed that drug release commenced earlier from multicomponent rods than from component fibers. Drug release from multicomponent rods lasted from day 30 to day 70. The release period of sterilized rods extended from day 23 to day 57. When compared to the original component fibers, the drug release from MC rods commenced earlier. The initial shear strength of MC rods was 135 MPa and decreased to 105 MPa during four weeks of immersion in phosphate buffer solution. Accordingly, heat pressing has a positive effect on drug release. After four weeks in hydrolysis, no disintegration was observed.

  13. Three-dimensional finite element analysis of platform switched implant.

    PubMed

    Moon, Se-Young; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom

    2017-02-01

    The purpose of this study was to analyze the influence of the platform switching concept on an implant system and peri-implant bone using three-dimensional finite element analysis. Two three-dimensional finite element models for wide platform and platform switching were created. In the wide platform model, a wide platform abutment was connected to a wide platform implant. In the platform switching model, the wide platform abutment of the wide platform model was replaced by a regular platform abutment. A contact condition was set between the implant components. A vertical load of 300 N was applied to the crown. The maximum von Mises stress values and displacements of the two models were compared to analyze the biomechanical behavior of the models. In the two models, the stress was mainly concentrated at the bottom of the abutment and the top surface of the implant in both models. However, the von Mises stress values were much higher in the platform switching model in most of the components, except for the bone. The highest von Mises values and stress distribution pattern of the bone were similar in the two models. The components of the platform switching model showed greater displacement than those of the wide platform model. Due to the stress concentration generated in the implant and the prosthodontic components of the platform switched implant, the mechanical complications might occur when platform switching concept is used.

  14. Three-dimensional finite element analysis of platform switched implant

    PubMed Central

    2017-01-01

    PURPOSE The purpose of this study was to analyze the influence of the platform switching concept on an implant system and peri-implant bone using three-dimensional finite element analysis. MATERIALS AND METHODS Two three-dimensional finite element models for wide platform and platform switching were created. In the wide platform model, a wide platform abutment was connected to a wide platform implant. In the platform switching model, the wide platform abutment of the wide platform model was replaced by a regular platform abutment. A contact condition was set between the implant components. A vertical load of 300 N was applied to the crown. The maximum von Mises stress values and displacements of the two models were compared to analyze the biomechanical behavior of the models. RESULTS In the two models, the stress was mainly concentrated at the bottom of the abutment and the top surface of the implant in both models. However, the von Mises stress values were much higher in the platform switching model in most of the components, except for the bone. The highest von Mises values and stress distribution pattern of the bone were similar in the two models. The components of the platform switching model showed greater displacement than those of the wide platform model. CONCLUSION Due to the stress concentration generated in the implant and the prosthodontic components of the platform switched implant, the mechanical complications might occur when platform switching concept is used. PMID:28243389

  15. Implant experience with an implantable hemodynamic monitor for the management of symptomatic heart failure.

    PubMed

    Steinhaus, David; Reynolds, Dwight W; Gadler, Fredrik; Kay, G Neal; Hess, Mike F; Bennett, Tom

    2005-08-01

    Management of congestive heart failure is a serious public health problem. The use of implantable hemodynamic monitors (IHMs) may assist in this management by providing continuous ambulatory filling pressure status for optimal volume management. The Chronicle system includes an implanted monitor, a pressure sensor lead with passive fixation, an external pressure reference (EPR), and data retrieval and viewing components. The tip of the lead is placed near the right ventricular outflow tract to minimize risk of sensor tissue encapsulation. Implant technique and lead placement is similar to that of a permanent pacemaker. After the system had been successfully implanted in 148 patients, the type and frequency of implant-related adverse events were similar to a single-chamber pacemaker implant. R-wave amplitude was 15.2 +/- 6.7 mV and the pressure waveform signal was acceptable in all but two patients in whom presence of artifacts required lead repositioning. Implant procedure time was not influenced by experience, remaining constant throughout the study. Based on this evaluation, permanent placement of an IHM in symptomatic heart failure patients is technically feasible. Further investigation is warranted to evaluate the use of the continuous hemodynamic data in management of heart failure patients.

  16. Melodic contour identification by cochlear implant listeners.

    PubMed

    Galvin, John J; Fu, Qian-Jie; Nogaki, Geraldine

    2007-06-01

    significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects' phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects' MCI performance; the improved MCI performance also generalized to improved FMI performance. Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users' music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users' music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners.

  17. Melodic Contour Identification by Cochlear Implant Listeners

    PubMed Central

    Galvin, John J.; Fu, Qian-Jie; Nogaki, Geraldine

    2013-01-01

    , MCI performance was significantly correlated with vowel recognition performance; FMI performance was not correlated with cochlear implant subjects’ phoneme recognition performance. Preliminary results also showed that the MCI training improved all subjects’ MCI performance; the improved MCI performance also generalized to improved FMI performance. Conclusions Preliminary data indicate that the closed-set MCI task is a viable approach toward quantifying an important component of cochlear implant users’ music perception. The improvement in MCI performance and generalization to FMI performance with training suggests that MCI training may be useful for improving cochlear implant users’ music perception and appreciation; such training may be necessary to properly evaluate patient performance, as acute measures may underestimate the amount of musical information transmitted by the cochlear implant device and received by cochlear implant listeners. PMID:17485980

  18. Implantable ultrasound devices

    NASA Astrophysics Data System (ADS)

    Vilkomerson, David; Chilipka, Thomas; Bogan, John; Blebea, John; Choudry, Rashad; Wang, John; Salvatore, Michael; Rotella, Vittorio; Soundararajan, Krishnan

    2008-03-01

    Using medical implants to wirelessly report physiological data is a technique that is rapidly growing. Ultrasound is well-suited for implants -- it requires little power and this form of radiated energy has no ill effects on the body. We report here on techniques we have developed in our experience gained in implanting over a dozen Doppler ultrasound flow-measuring implants in dogs. The goal of our implantable device is to measure flow in an arterial graft. To accomplish this, we place a Doppler transducer in the wall of a graft and an implant unit under the skin that energizes the 20 MHz Doppler transducer system, either when started by external command or by internal timetable. The implant records the digitized Doppler real and imaginary channels and transmits the data to a nearby portable computer for storage and evaluation. After outlining the overall operation of the system, we will concentrate on three areas of implant design where special techniques are required: ensuring safety, including biocompatibility to prevent the body from reacting to its invasion; powering the device, including minimizing energy used so that a small battery can provide long-life; and transmitting the data obtained.

  19. Batteryless implanted echosonometer

    NASA Technical Reports Server (NTRS)

    Kojima, G. K.

    1977-01-01

    Miniature ultrasonic echosonometer implanted within laboratory animals obtains energy from RF power oscillator that is electronically transduced via induction loop to power receiving loop located just under animal's skin. Method of powering device offers significant advantages over those in which battery is part of implanted package.

  20. Implantable, Ingestible Electronic Thermometer

    NASA Technical Reports Server (NTRS)

    Kleinberg, Leonard

    1987-01-01

    Small quartz-crystal-controlled oscillator swallowed or surgically implanted provides continuous monitoring of patient's internal temperature. Receiver placed near patient measures oscillator frequency, and temperature inferred from previously determined variation of frequency with temperature. Frequency of crystal-controlled oscillator varies with temperature. Circuit made very small and implanted or ingested to measure internal body temperature.

  1. A no bleed implant.

    PubMed

    Ersek, R A; Navarro, J A; Nemeth, D Z; Sas, G

    1993-01-01

    Breast implants have evolved from the original saline-filled, smooth-surfaced silicone rubber bag to silicone gel-filled smooth-walled sacs to a combination of a silicone gel-filled bag within a saline-filled sac, and, most recently, a reversed, double-lumen implant with a saline bag inside of a gel-filled bag. Texture-surfaced implants were first used in 1970 when the standard silicone gel-filled implant was covered with a polyurethane foam. Because of concerns about the degradation products of this foam, they were removed from the market in 1991. In 1975 double-lumen silicone textured implants were developed, followed by silicone gel-filled textured implants. In 1990 a new radiolucent, biocompatible gel was produced that reduced the problem of radioopacity of silicone implants. Because of the gel's sufficiently low coefficient of friction, leakage caused by fold flaw fracture may also be decreased. We present a case where this new biocompatible gel implant was repositioned after four months. The resulting scar capsule in this soft breast was thin [< 0.002 cm (0.008 in.)] and evenly textured as a mirror image of the textured silicone surface. Scanning electron microscopy and x-ray defraction spectrophotometry revealed no silicone bleed.

  2. Smoking and dental implants

    PubMed Central

    Kasat, V.; Ladda, R.

    2012-01-01

    Smoking is a prevalent behaviour in the population. The aim of this review is to bring to light the effects of smoking on dental implants. These facts will assist dental professionals when implants are planned in tobacco users. A search of “PubMed” was made with the key words “dental implant,” “nicotine,” “smoking,” “tobacco,” and “osseointegration.” Also, publications on tobacco control by the Government of India were considered. For review, only those articles published from 1988 onward in English language were selected. Smoking has its influence on general as well as oral health of an individual. Tobacco negatively affects the outcome of almost all therapeutic procedures performed in the oral cavity. The failure rate of implant osseointegration is considerably higher among smokers, and maintenance of oral hygiene around the implants and the risk of peri-implantitis are adversely affected by smoking. To increase implant survival in smokers, various protocols have been recommended. Although osseointegrated dental implants have become the state of the art for tooth replacement, they are not without limitations or complications. In this litigious era, it is extremely important that the practitioner clearly understands and is able and willing to convey the spectrum of possible complications and their frequency to the patients. PMID:24478965

  3. Batteryless implanted echosonometer

    NASA Technical Reports Server (NTRS)

    Kojima, G. K.

    1977-01-01

    Miniature ultrasonic echosonometer implanted within laboratory animals obtains energy from RF power oscillator that is electronically transduced via induction loop to power receiving loop located just under animal's skin. Method of powering device offers significant advantages over those in which battery is part of implanted package.

  4. Implantable CMOS Biomedical Devices

    PubMed Central

    Ohta, Jun; Tokuda, Takashi; Sasagawa, Kiyotaka; Noda, Toshihiko

    2009-01-01

    The results of recent research on our implantable CMOS biomedical devices are reviewed. Topics include retinal prosthesis devices and deep-brain implantation devices for small animals. Fundamental device structures and characteristics as well as in vivo experiments are presented. PMID:22291554

  5. Teeth and implants.

    PubMed

    Palmer, R

    1999-08-28

    An osseointegrated implant restoration may closely resemble a natural tooth. However, the absence of a periodontal ligament and connective tissue attachment via cementum, results in fundamental differences in the adaptation of the implant to occlusal forces, and the structure of the gingival cuff.

  6. Percutaneous and skeletal biocarbon implants

    NASA Technical Reports Server (NTRS)

    Mooney, V.

    1977-01-01

    Review of carbon implants developed by NASA discussed four different types of implants and subsequent improvements. Improvements could be of specific interest to rehabilitation centers and similar organizations.

  7. Percutaneous and skeletal biocarbon implants

    NASA Technical Reports Server (NTRS)

    Mooney, V.

    1977-01-01

    Review of carbon implants developed by NASA discussed four different types of implants and subsequent improvements. Improvements could be of specific interest to rehabilitation centers and similar organizations.

  8. Graphene for Biomedical Implants

    NASA Astrophysics Data System (ADS)

    Moore, Thomas; Podila, Ramakrishna; Alexis, Frank; Rao, Apparao; Clemson Bioengineering Team; Clemson Physics Team

    2013-03-01

    In this study, we used graphene, a one-atom thick sheet of carbon atoms, to modify the surfaces of existing implant materials to enhance both bio- and hemo-compatibility. This novel effort meets all functional criteria for a biomedical implant coating as it is chemically inert, atomically smooth and highly durable, with the potential for greatly enhancing the effectiveness of such implants. Specifically, graphene coatings on nitinol, a widely used implant and stent material, showed that graphene coated nitinol (Gr-NiTi) supports excellent smooth muscle and endothelial cell growth leading to better cell proliferation. We further determined that the serum albumin adsorption on Gr-NiTi is greater than that of fibrinogen, an important and well understood criterion for promoting a lower thrombosis rate. These hemo-and biocompatible properties and associated charge transfer mechanisms, along with high strength, chemical inertness and durability give graphene an edge over most antithrombogenic coatings for biomedical implants and devices.

  9. Comparative Clinical Study of Conventional Dental Implants and Mini Dental Implants for Mandibular Overdentures: A Randomized Clinical Trial.

    PubMed

    Aunmeungtong, Weerapan; Kumchai, Thongnard; Strietzel, Frank P; Reichart, Peter A; Khongkhunthian, Pathawee

    2017-04-01

    Dental implant-retained overdentures have been chosen as the treatment of choice for complete mandibular removable dentures. Dental implants, such as mini dental implants, and components for retaining overdentures, are commercially available. However, comparative clinical studies comparing mini dental implants and conventional dental implants using different attachment for implant-retained overdentures have not been well documented. To compare the clinical outcomes of using two mini dental implants with Equator(®) attachments, four mini dental implants with Equator attachments, or two conventional dental implants with ball attachments, by means of a randomized clinical trial. Sixty patients received implant-retained mandibular overdentures in the interforaminal region. The patients were divided into three groups. In Groups 1 and 2, two and four mini dental implants, respectively, were placed and immediately loaded by overdentures, using Equator(®) attachments. In Group 3, conventional implants were placed. After osseointegration, the implants were loaded by overdentures, using ball attachments. The study distribution was randomized and double-blinded. Outcome measures included changes in radiological peri-implant bone level from surgery to 12 months postinsertion, prosthodontic complications and patient satisfaction. The cumulative survival rate in the three clinical groups after one year was 100%. There was no significant difference (p < 0.05) in clinical results regarding the number (two or four) of mini dental implants with Equator attachments. However, there was a significant difference in marginal bone loss and patient satisfaction between those receiving mini dental implants with Equator attachments and conventional dental implants with ball attachments. The marginal bone resorption in Group 3 was significantly higher than in Groups 1 and 2 (p < 0.05); there were no significant differences between Groups 1 and 2. There was no significant difference

  10. Availability of Total Knee Arthroplasty Implants for Metal Hypersensitivity Patients

    PubMed Central

    Ajwani, Sanil Harji; Charalambous, Charalambos P.

    2016-01-01

    Purpose To provide information on the type of “hypersensitivity-friendly” components available for primary total knee arthroplasty (TKA) in the current market. Materials and Methods Implant manufactures were identified using the 2013 National Joint Registries of the United Kingdom and Sweden and contacted to obtain information about the products they offer for patients with metal hypersensitivity. Results Information on 23 TKA systems was provided by 13 implant manufacturers. Of these, 15 systems had options suitable for metal hypersensitivity patients. Two types of “hypersensitivity-friendly” components were identified: 10 implants were cobalt chrome prostheses with a “hypersensitivity-friendly” outer coating and 5 implants were made entirely from non-cobalt chrome alloys. Conclusions The results of this study suggest that several hypersensitivity TKA options exist, some of which provide the same designs and surgical techniques as the conventional implants. The information in this study can guide TKA surgeons in making informed choices about implants and identifying implants that could be examined in future controlled studies comparing outcomes between “hypersensitivity-friendly” and conventional implants. PMID:27894179

  11. Stress and strain distribution in three different mini dental implant designs using in implant retained overdenture: a finite element analysis study

    PubMed Central

    AUNMEUNGTONG, W.; KHONGKHUNTHIAN, P.; RUNGSIYAKULL, P.

    2016-01-01

    SUMMARY Finite Element Analysis (FEA) has been used for prediction of stress and strain between dental implant components and bone in the implant design process. Purpose Purpose of this study was to characterize and analyze stress and strain distribution occurring in bone and implants and to compare stress and strain of three different implant designs. Materials and methods Three different mini dental implant designs were included in this study: 1. a mini dental implant with an internal implant-abutment connection (MDIi); 2. a mini dental implant with an external implant-abutment connection (MDIe); 3. a single piece mini dental implant (MDIs). All implant designs were scanned using micro-CT scans. The imaging details of the implants were used to simulate models for FEA. An artificial bone volume of 9×9 mm in size was constructed and each implant was placed separately at the center of each bone model. All bone-implant models were simulatively loaded under an axial compressive force of 100 N and a 45-degree force of 100 N loading at the top of the implants using computer software to evaluate stress and strain distribution. Results There was no difference in stress or strain between the three implant designs. The stress and strain occurring in all three mini dental implant designs were mainly localized at the cortical bone around the bone-implant interface. Oblique 45° loading caused increased deformation, magnitude and distribution of stress and strain in all implant models. Conclusions Within the limits of this study, the average stress and strain in bone and implant models with MDIi were similar to those with MDIe and MDIs. The oblique 45° load played an important role in dramatically increased average stress and strain in all bone-implant models. Clinical implications Mini dental implants with external or internal connections have similar stress distribution to single piece mini dental implants. In clinical situations, the three types of mini dental implant

  12. Peri-implant mucositis and peri-implantitis: bacterial infection.

    PubMed

    Khammissa, R A G; Feller, L; Meyerov, R; Lemmer, J

    2012-03-01

    Osseointegrated dental implants have a ong-term success rate of over 90%, but may be threatened by peri-implant mucostis and peri-implantitis, bacteria biofilm-induced inflammatory conditions. While peri-implant mucositis is a reversible inflammatory condition confined to the peri-implant soft-tissue unit, peri-implantitis is characterised by progressive inflammatory destruction of the crest of the alveolar bone supporting the implant, by increased peri-implant probing depths, and by bleeding and/or suppuration on probing. Effective treatment of peri-implant mucositis will prevent the development of peri-implantitis. Plaque accumulation on the implant/abutment surface juxtaposed to the junctional epithelium and to the connective tissue zone of the peri-implant soft-tissue unit induces the development of peri-implant mucositis which can subsequently progress to peri-implantitis. The aim of this paper is to review some aspects of bacterial infection of the tissue supporting dental implants, and to explore how to maintain the healthy peri-implant soft-tissue unit.

  13. [Extra-oral implants: principal areas of implantation].

    PubMed

    Badie-Modiri, B; Kaplanski, P

    2001-08-01

    The success of extra-oral implants raises a certain number of technical and medical problems. Among these, the anatomy of the implant zone and bone quality are determining factors for osteointegration of the implants. We describe the principal zones of implantation detailing the risks involved in each area.

  14. Foreign body response to subcutaneous implants in diabetic rats.

    PubMed

    Socarrás, Teresa Oviedo; Vasconcelos, Anilton C; Campos, Paula P; Pereira, Nubia B; Souza, Jessica P C; Andrade, Silvia P

    2014-01-01

    Implantation of synthetic matrices and biomedical devices in diabetic individuals has become a common procedure to repair and/or replace biological tissues. However, an adverse foreign body reaction that invariably occurs adjacent to implant devices impairing their function is poorly characterized in the diabetic environment. We investigated the influence of this condition on the abnormal tissue healing response in implants placed subcutaneously in normoglycemic and streptozotocin-induced diabetes in rats. In polyether-polyurethane sponge discs removed 10 days after implantation, the components of the fibrovascular tissue (angiogenesis, inflammation, fibrogenesis, and apoptosis) were assessed. Intra-implant levels of hemoglobin and vascular endothelial growth factor were not different after diabetes when compared with normoglycemic counterparts. However, there were a lower number of vessels in the fibrovascular tissue from diabetic rats when compared with vessel numbers in implants from non-diabetic animals. Overall, the inflammatory parameters (neutrophil accumulation--myeloperoxidase activity, tumor necrosis factor alpha, and monocyte chemotactic protein-1 levels and mast cell counting) increased in subcutaneous implants after diabetes induction. However, macrophage activation (N-acetyl-β-D-glucosaminidase activity) was lower in implants from diabetic rats when compared with those from normoglycemic animals. All fibrogenic markers (transforming growth factor beta 1 levels, collagen deposition, fibrous capsule thickness, and foreign body giant cells) decreased after diabetes, whereas apoptosis (TUNEL) increased. Our results showing that hyperglycemia down regulates the main features of the foreign body reaction induced by subcutaneous implants in rats may be relevant in understanding biomaterial integration and performance in diabetes.

  15. Cochlear Implants:System Design, Integration and Evaluation

    PubMed Central

    Rebscher, Stephen; Harrison, William V.; Sun, Xiaoan; Feng, Haihong

    2009-01-01

    As the most successful neural prosthesis, cochlear implants have provided partial hearing to more than 120,000 persons worldwide; half of which being pediatric users who are able to develop nearly normal language. Biomedical engineers have played a central role in the design, integration and evaluation of the cochlear implant system, but the overall success is a result of collaborative work with physiologists, psychologists, physicians, educators, and entrepreneurs. This review presents broad yet in-depth academic and industrial perspectives on the underlying research and ongoing development of cochlear implants. The introduction accounts for major events and advances in cochlear implants, including dynamic interplays among engineers, scientists, physicians, and policy makers. The review takes a system approach to address critical issues from design and specifications to integration and evaluation. First, the cochlear implant system design and specifications are laid out. Second, the design goals, principles, and methods of the subsystem components are identified from the external speech processor and radio frequency transmission link to the internal receiver, stimulator and electrode arrays. Third, system integration and functional evaluation are presented with respect to safety, reliability, and challenges facing the present and future cochlear implant designers and users. Finally, issues beyond cochlear implants are discussed to address treatment options for the entire spectrum of hearing impairment as well as to use the cochlear implant as a model to design and evaluate other similar neural prostheses such as vestibular and retinal implants. PMID:19946565

  16. Cochlear implantation in children under 12 months of age.

    PubMed

    McKinney, Samantha

    2017-10-01

    Children with congenital hearing loss are being identified earlier, leading to earlier intervention. Current US Food and Drug Administration (FDA) criteria states a child must be 12 months or older for cochlear implantation. The purpose of this article is to review recent publications regarding the benefits of implanting infants under 12 months of age. Topics include: safety and efficacy of surgery, speech and language acquisition outcomes, audiologic components, and limitations. Since the early 1990s, the candidacy criteria evolved drastically. However, the FDA criteria for cochlear implantation in children has remained at 12 months of age or older since 2000. Recent research indicates implanting below 12 months of age a safe and effective procedure. Speech and language outcomes showed better speech and language advantages. In addition, infants implanted earlier showed normal auditory skills as early as 3 months post cochlear implant activation. This article will also address recent findings on the limitations of earlier implantation. Recent research demonstrates positive outcomes in children implanted under 12 months of age. Developing research on earlier implantation could lead to a change in the current FDA criteria allowing infants to reach their speech and hearing potential faster.

  17. Predoctoral dental implant education at King Abdulaziz University

    PubMed Central

    Aljohani, Hind Ahmed; AlGhamdi, Ali Saad Thafeed

    2009-01-01

    Objective In June 2008, a survey of freshly graduated dental students of King Abdulaziz University Jeddah was conducted to evaluate the extent of their exposure to oral implantology and their knowledge of some basic principles of dental implant treatment. Materials and methods Multiple-choice questionnaires were given to the fresh graduate dental students of King Abdulaziz University Jeddah to answer. Sixty-six students responded out of 86, yielding a response rate of 76.7%. Results Majority of the students (78.8%) thought that they did not have enough lectures about dental implants and all of them thought that they did not have enough training in dental implant. Most of the students were not familiar with different dental implant systems (61.1%), designs (60.6%) or sizes (74.2%). Majority of the students were lacking the knowledge about basic principles of dental implant treatment. At King Abdulaziz University, Faculty of Dentistry, implant dentistry is taught to the students in the form of implant-related lectures incorporated into their periodontic, oral surgery and prosthodontic courses with one or two lectures given on dental implant in each course. Conclusion There is an urgent need to develop a well-structured implant course that includes didactic, laboratory, preclinical and clinical components at the undergraduate curriculum of King Abdulaziz University Faculty of Dentistry. PMID:23960472

  18. Immunopathologic effects of silicone breast implants.

    PubMed Central

    Teuber, S S; Yoshida, S H; Gershwin, M E

    1995-01-01

    Silicone-gel breast implants have been associated with a myriad of autoimmune and connective tissue disorders by anecdotal reports and small observational series. To date, no prospective epidemiologic studies have been done to substantiate these observations, but an increasing body of literature is being developed and older studies are being recognized that point to immunotoxic or inflammatory effects of these breast implant components. The development of disease due to implants would depend on the interaction of genetic host factors so that only a few patients would potentially be at risk. Based on the example of other chemically mediated disorders, such as scleroderma in association with silica exposure, latency periods of more than 30 years before disease develops may be possible. Herein we review studies on silicone and immunity. PMID:7785255

  19. Dental Implant Systems

    PubMed Central

    Oshida, Yoshiki; Tuna, Elif B.; Aktören, Oya; Gençay, Koray

    2010-01-01

    Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities. PMID:20480036

  20. Single implant tooth replacement.

    PubMed

    Briley, T F

    1998-01-01

    It has been shown that direct bone anchorage of dental implants will provide long-term predictability for single tooth implants and multi-unit implants. The function of implant-supported restoration is now routinely achieved. The real challenge facing the restorative dentist and laboratory technician is to achieve optimal aesthetics. The learning objective of this article is to review the prosthodontic procedures essential to maximizing natural aesthetics in implant supported restorations. It will provide a review of master impression techniques, prepable titanium abutments and designing the cement on restoration. Particular emphasis is directed to the soft tissue model from which a series of sequenced techniques can be followed to achieve optimal aesthetics. Analysis of the implant alignment with regard to the neighboring teeth will result in having to make a choice of which prepable abutment will maximize the aesthetic result. The following case outlines how to replace a single missing tooth using an externally hexed implant system and a prefabricated titanium abutment on a 26-year-old male patient.

  1. Boron implanted strontium titanate

    NASA Astrophysics Data System (ADS)

    Cooper, C. J. M.

    Single crystals of strontium titanate implanted with boron were found to have highly conductive surface layers. The effects of varying dose from 10 to the 16th power to 10 to the 17th power ions/sq cm, implantation voltage from 50 to 175 keV and annealing conditions on the room temperature surface resistance and Hall mobility are presented. Variation of the implantation voltage did not have a major effect on the sheet resistances obtained by boron implantation of strontium titanate, while dose and annealing conditions have major effects. Doses of 5 x 10 to the 16th power ions/sq cm required annealing on the order of one hour at 500 K for maximum reduction of the room temperature resistance in the implanted layer. Samples implanted with a dose of 1 x 10 to the 17th power ions/sq cm required slightly higher temperatures (approximately 575 K) to obtain a minimum resistance at room temperature. Long term (several weeks) room temperature annealing was found to occur in high dose samples. After one to two months at room temperature followed by an anneal to 575 K, the surface resistances were found to be lower than those produced by the annealing of a freshly implanted sample to 575 K.

  2. Optimization of dental implantation

    NASA Astrophysics Data System (ADS)

    Dol, Aleksandr V.; Ivanov, Dmitriy V.

    2017-02-01

    Modern dentistry can not exist without dental implantation. This work is devoted to study of the "bone-implant" system and to optimization of dental prostheses installation. Modern non-invasive methods such as MRI an 3D-scanning as well as numerical calculations and 3D-prototyping allow to optimize all of stages of dental prosthetics. An integrated approach to the planning of implant surgery can significantly reduce the risk of complications in the first few days after treatment, and throughout the period of operation of the prosthesis.

  3. Oxygen implanter for simox

    NASA Astrophysics Data System (ADS)

    Guerra, M.; Benveniste, V.; Ryding, G.; Douglas-Hamilton, D. H.; Reed, M.; Gagne, G.; Armstrong, A.; Mack, M.

    1985-01-01

    Interest in silicon or) insulator (SOI) technology has led to the development of several alternatives to silicon on sapphire. One of the most promising techniques makes use of an ion implanter to form a buried oxide layer directly in the silicon substrate. To have useful single crystalline silicon on top of the oxide layer, it is necessary to do the implant at high wafer temperatures and rely on solid phase epitaxy to maintain surface structure. A high current, 160 keV, Nova ion implanter has been adapted to provide the ability to perform oxygen implants at elevated temperatures. The operator is free to choose any temperature in the range between 400°C and 600°C. The system then preheats the wafers to the selected temperature before the implant begins. A novel technique for providing both heating and cooling capability to the end station is employed. An infrared signal from the wafers is monitored by a room temperature lead salt detector. This signal is then used by a servo-loop to control the heating of the end station and to maintain the wafer temperature to within ± 20°C during the implant. High doses of the type necessary to form a silicon dioxide buried layer require long lived, high current oxygen sources. An oxygen source has been specially developed, which provides as much as 10 mA of ion current. At a 6 mA output, source lifetimes in excess of 40 hours have been achieved. The implanter uses a specifically designed high temperature disk, which holds ten wafers, each of four inch diameter. A variety of implant angles lying between 0° and 15° is available. The beam is scanned mechanically and an electron flood gun can be used to prevent wafer charging. Special thermal barriers have been employed to protect the apparatus from extreme temperatures and to make the heating sequence more efficient and more rapid. Every effort has been made to avoid contamination of the implant. The implant disk, for example, is overcoated with silicon monoxide. Silicon

  4. Biomedical implantable microelectronics.

    PubMed

    Meindl, J D

    1980-10-17

    Innovative applications of microelectronics in new biomedical implantable instruments offer a singular opportunity for advances in medical research and practice because of two salient factors: (i) beyond all other types of biomedical instruments, implants exploit fully the inherent technical advantages--complex functional capability, high reliability, lower power drain, small size and weight-of microelectronics, and (ii) implants bring microelectronics into intimate association with biological systems. The combination of these two factors enables otherwise impossible new experiments to be conducted and new paostheses developed that will improve the quality of human life.

  5. Transcatheter aortic valve implantation.

    PubMed

    Oliemy, Ahmed; Al-Attar, Nawwar

    2014-01-01

    Transcatheter aortic valve implantation was developed to offer a therapeutic solution to patients with severe symptomatic aortic stenosis who are not candidates for conventional aortic valve replacement. The improvement in transcatheter aortic valve implantation outcomes is still of concern in the areas of stroke, vascular injury, heart block, paravalvular regurgitation and valve durability. Concomitantly, the progress, both technical and in terms of material advances of transcatheter valve systems, as well as in patient selection, renders transcatheter aortic valve implantation an increasingly viable treatment for more and more patients with structural heart disease.

  6. Implant strategies during feeding: impact on carcass grades and consumer acceptability.

    PubMed

    Roeber, D L; Cannell, R C; Belk, K E; Miller, R K; Tatum, J D; Smith, G C

    2000-07-01

    Anabolic growth promotants influence beef grade factors and Warner-Bratzler shear force of steaks. No study has assessed the consumer acceptability of beef derived from implanted cattle. This study determined beef carcass grades and consumer acceptability for cooked beef from unimplanted (control) cattle and from cattle implanted with one of seven different implant strategies (initial implant/implant at 59 d = Encore & Component T-S/no implant, Ralgro/Synovex Plus, Ralgro/Revalor-S, Revalor-S/Revalor-S, Revalor-S/no implant, no implant/Synovex Plus, and Synovex Plus/no implant). British crossbred steers (n = 448) were allocated randomly into one of eight pens for each of the control and seven treatment groups. Carcass quality and yield grade (n = 403) and Warner-Bratzler shear force (n = 298) data were collected by trained personnel. Twenty steaks per control or treatment group were selected randomly for use in consumer sensory evaluation. Steaks were evaluated by consumers for overall like, tenderness like, tenderness level, flavor like, flavor intensity, and juiciness level using 9-point, end-anchored hedonic scales. Control carcasses had smaller (P < .05) longissimus muscle areas than carcasses in all treatment groups except those receiving Encore & Component T S/no implant, Ralgro/Synovex Plus, or Revalor S/no implant. Control carcasses had higher (P < .05) marbling scores than carcasses in all treatment groups except those receiving Ralgro/Revalor-S or Encore & Component T-S/no implant. Steaks from control steers had lower (P < .05) Warner-Bratzler shear force values than steaks from steers given Revalor-S/no implant. Consumer ratings for tenderness like and tenderness level were influenced (P < .05) by implant strategy. Effects of implant strategy on overall like, flavor like, and flavor intensity approached significance (P = .07 to .09). Consumers rated steaks from unimplanted steers as more tender (tenderness level; P < .05) than steaks from all treatment

  7. Visualization of spiral ganglion neurites within the scala tympani with a cochlear implant in situ

    PubMed Central

    Chikar, Jennifer A.; Batts, Shelley A.; Pfingst, Bryan E.; Raphael, Yehoash

    2009-01-01

    Current cochlear histology methods do not allow in situ processing of cochlear implants. The metal components of the implant preclude standard embedding and mid-modiolar sectioning, and whole mounts do not have the spatial resolution needed to view the implant within the scala tympani. One focus of recent auditory research is the regeneration of structures within the cochlea, particularly the ganglion cells and their processes, and there are multiple potential benefits to cochlear implant users from this work. To facilitate experimental investigations of auditory nerve regeneration performed in conjunction with cochlear implantation, it is critical to visualize the cochlear tissue and the implant together to determine if the nerve has made contact with the implant. This paper presents a novel histological technique that enables simultaneous visualization of the in situ cochlear implant and neurofilament – labeled nerve processes within the scala tympani, and the spatial relationship between them. PMID:19428528

  8. Shape optimization of tibial prosthesis components

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Davy, D. T.

    1993-01-01

    NASA technology and optimal design methodologies originally developed for the optimization of composite structures (engine blades) are adapted and applied to the optimization of orthopaedic knee implants. A method is developed enabling the shape tailoring of the tibial components of a total knee replacement implant for optimal interaction within the environment of the tibia. The shape of the implant components are optimized such that the stresses in the bone are favorably controlled to minimize bone degradation, to improve the mechanical integrity of the implant/interface/bone system, and to prevent failures of the implant components. A pilot tailoring system is developed and the feasibility of the concept is demonstrated and evaluated. The methodology and evolution of the existing aerospace technology from which this pilot optimization code was developed is also presented and discussed. Both symmetric and unsymmetric in-plane loading conditions are investigated. The results of the optimization process indicate a trend toward wider and tapered posts as well as thicker backing trays. Unique component geometries were obtained for the different load cases.

  9. The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog.

    PubMed

    Abrahamsson, I; Berglundh, T; Wennström, J; Lindhe, J

    1996-09-01

    The aim of this study of the present experiment was to study the marginal periimplant tissues at intentionally non-submerged (1-stage implants) and initially submerged and subsequently exposed implants (2-stage implants). 5 beagle dogs, about 1-year-old, were used, 3 months after the extraction of the mandibular premolars, fixtures of the Astra Tech Implants Dental System, the Brånemark System and the Bonefit--ITI system were installed. In each mandibular quadrant, 1 fixture of each implant system was installed in a randomised order. The installation procedure followed the recommendations given in the manuals for each system. Thus, following installation, the bone crest coincided with the fixture margin of the Astra Tech Implants Dental System and the Brånemark System, whereas the border between the plasma sprayed and the machined surface of the Bonefit-ITI implant system was positioned at the level of the bone crest. Following a healing period of 3 months, abutment connection was carried out in the 2-stage systems (the Astra Tech Implants Dental System and the Brånemark system). A 6-month period of plaque control was initiated. The animals were sacrificed and biopsies representing each important region dissected. The tissue samples were prepared for light microscopy and exposed to histometric and morphometric measurements. The mucosal barrier which formed to the titanium surface following 1-stage and 2-stage implant installations comprised an epithelial and a connective tissue component, which for that 3 systems studied, had similar dimensions and composition. The amount of lamellar bone contained in the periimplant region close to the fixture part of the 3-implant systems was almost identical. It is suggested that correctly performed implant installation may ensure proper conditions for both and hard tissue healing, and that the geometry of the titanium implant seems to be of limited importance.

  10. DEALING WITH DENTAL IMPLANT FAILURES

    PubMed Central

    Levin, Liran

    2008-01-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them. PMID:19089213

  11. Dealing with dental implant failures.

    PubMed

    Levin, L

    2010-01-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  12. Dealing with dental implant failures.

    PubMed

    Levin, Liran

    2008-01-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options.When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  13. Dealing with dental implant failures.

    PubMed

    Levin, L

    2010-07-01

    An implant-supported restoration offers a predictable treatment for tooth replacement. Reported success rates for dental implants are high. Nevertheless, failures that mandate immediate implant removal do occur. The consequences of implant removal jeopardize the clinician's efforts to accomplish satisfactory function and esthetics. For the patient, this usually involves further cost and additional procedures. The aim of this paper is to describe different methods and treatment modalities to deal with dental implant failure. The main topics for discussion include identifying the failing implant, implants replacing failed implants at the exact site, and the use of other restorative options. When an implant fails, a tailor made treatment plan should be provided to each patient according to all relevant variables. Patients should be informed regarding all possible treatment modalities following implant failure and give their consent to the most appropriate treatment option for them.

  14. Breast Reconstruction with Implants

    MedlinePlus

    ... removes your breast to treat or prevent breast cancer. One type of breast reconstruction uses breast implants — silicone devices filled with silicone gel or salt water (saline) — to reshape your breasts. Breast reconstruction ...

  15. Biocompatibility of surgical implants

    NASA Technical Reports Server (NTRS)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  16. Biocompatibility of surgical implants

    NASA Technical Reports Server (NTRS)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  17. Implantable Medical Devices

    MedlinePlus

    ... a Heart Attack Treatment of a Heart Attack Life After a Heart Attack Heart Failure About Heart Failure ... Attack Introduction Medications Surgical Procedures Implantable Medical Devices • Life After a Heart Attack • Heart Attack Tools & Resources • Support ...

  18. Urinary incontinence - injectable implant

    MedlinePlus

    Intrinsic sphincter deficiency repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... Urine leakage that gets worse Pain where the injection was done Allergic reaction to the material Implant ...

  19. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  20. Breast reconstruction - implants

    MedlinePlus

    ... cosmetic surgery after breast cancer can improve your sense of well-being and your quality of life. Alternative Names Breast implants surgery References Roehl KR, Wilhelmi BJ, Phillips LG. Breast reconstruction. ...

  1. A Fully Implantable 96-channel Neural Data Acquisition System

    PubMed Central

    Rizk, Michael; Bossetti, Chad A; Jochum, Thomas A; Callender, Stephen H; Nicolelis, Miguel A L; Turner, Dennis A; Wolf, Patrick D

    2009-01-01

    A fully implantable neural data acquisition system is a key component of a clinically viable brain-machine interface. This type of system must communicate with the outside world and obtain power without the use of wires that cross through the skin. We present a 96-channel fully implantable neural data acquisition system. This system performs spike detection and extraction within the body and wirelessly transmits data to an external unit. Power is supplied wirelessly through the use of inductively-coupled coils. The system was implanted acutely in sheep and successfully recorded, processed, and transmitted neural data. Bidirectional communication between the implanted system and an external unit was successful over a range of 2 m. The system is also shown to integrate well into a brain-machine interface. This demonstration of a high channel-count fully implanted neural data acquisition system is a critical step in the development of a clinically viable brain-machine interface. PMID:19255459

  2. A fully implantable 96-channel neural data acquisition system

    NASA Astrophysics Data System (ADS)

    Rizk, Michael; Bossetti, Chad A.; Jochum, Thomas A.; Callender, Stephen H.; Nicolelis, Miguel A. L.; Turner, Dennis A.; Wolf, Patrick D.

    2009-04-01

    A fully implantable neural data acquisition system is a key component of a clinically viable brain-machine interface. This type of system must communicate with the outside world and obtain power without the use of wires that cross through the skin. We present a 96-channel fully implantable neural data acquisition system. This system performs spike detection and extraction within the body and wirelessly transmits data to an external unit. Power is supplied wirelessly through the use of inductively coupled coils. The system was implanted acutely in sheep and successfully recorded, processed and transmitted neural data. Bidirectional communication between the implanted system and an external unit was successful over a range of 2 m. The system is also shown to integrate well into a brain-machine interface. This demonstration of a high channel-count fully implanted neural data acquisition system is a critical step in the development of a clinically viable brain-machine interface.

  3. A fully implantable 96-channel neural data acquisition system.

    PubMed

    Rizk, Michael; Bossetti, Chad A; Jochum, Thomas A; Callender, Stephen H; Nicolelis, Miguel A L; Turner, Dennis A; Wolf, Patrick D

    2009-04-01

    A fully implantable neural data acquisition system is a key component of a clinically viable brain-machine interface. This type of system must communicate with the outside world and obtain power without the use of wires that cross through the skin. We present a 96-channel fully implantable neural data acquisition system. This system performs spike detection and extraction within the body and wirelessly transmits data to an external unit. Power is supplied wirelessly through the use of inductively coupled coils. The system was implanted acutely in sheep and successfully recorded, processed and transmitted neural data. Bidirectional communication between the implanted system and an external unit was successful over a range of 2 m. The system is also shown to integrate well into a brain-machine interface. This demonstration of a high channel-count fully implanted neural data acquisition system is a critical step in the development of a clinically viable brain-machine interface.

  4. Trabecular metal tibial knee component still stable at 10 years.

    PubMed

    Henricson, Anders; Nilsson, Kjell G

    2016-10-01

    Background and purpose - Total knee replacement (TKR) in younger patients using cemented components has shown inferior results, mainly due to aseptic loosening. Excellent clinical results have been reported with components made of trabecular metal (TM). In a previous report, we have shown stabilization of the TM tibial implants for up to 5 years. In this study, we compared the clinical and RSA results of these uncemented implants with those of cemented implants. Patients and methods - 41 patients (47 knees) aged ≤ 60 years underwent TKR. 22 patients (26 knees) received an uncemented monoblock cruciate-retaining (CR) tibial component (TM) and 19 patients (21 knees) received a cemented NexGen Option CR tibial component. Follow-up examination was done at 10 years, and 16 patients (19 knees) with TM tibial components and 17 patients (18 knees) with cemented tibial components remained for analysis. Results - 1 of 19 TM implants was revised for infection, 2 of 18 cemented components were revised for knee instability, and no revisions were done for loosening. Both types of tibial components migrated in the first 3 months, the TM group to a greater extent than the cemented group. After 3 months, both groups were stable during the next 10 years. Interpretation - The patterns of migration for uncemented TM implants and cemented tibial implants over the first 10 years indicate that they have a good long-term prognosis regarding fixation.

  5. Trabecular metal tibial knee component still stable at 10 years

    PubMed Central

    Henricson, Anders; Nilsson, Kjell G

    2016-01-01

    Background and purpose Total knee replacement (TKR) in younger patients using cemented components has shown inferior results, mainly due to aseptic loosening. Excellent clinical results have been reported with components made of trabecular metal (TM). In a previous report, we have shown stabilization of the TM tibial implants for up to 5 years. In this study, we compared the clinical and RSA results of these uncemented implants with those of cemented implants. Patients and methods 41 patients (47 knees) aged ≤ 60 years underwent TKR. 22 patients (26 knees) received an uncemented monoblock cruciate-retaining (CR) tibial component (TM) and 19 patients (21 knees) received a cemented NexGen Option CR tibial component. Follow-up examination was done at 10 years, and 16 patients (19 knees) with TM tibial components and 17 patients (18 knees) with cemented tibial components remained for analysis. Results 1 of 19 TM implants was revised for infection, 2 of 18 cemented components were revised for knee instability, and no revisions were done for loosening. Both types of tibial components migrated in the first 3 months, the TM group to a greater extent than the cemented group. After 3 months, both groups were stable during the next 10 years. Interpretation The patterns of migration for uncemented TM implants and cemented tibial implants over the first 10 years indicate that they have a good long-term prognosis regarding fixation PMID:27357222

  6. Exactech Opteon Femoral Component Fracture 12 Years after Arthroplasty

    PubMed Central

    Patel, Shaun P.; Antoci, Valentin; Kadzielski, John J.; Vrahas, Mark S.

    2016-01-01

    Arthroplasty implant fracture is a rare but critical complication that requires difficult revision surgery, often with poor results, patient disability, and significant cost. Several reports show component fracture either at the stem or at the neck interface after a relatively short postoperative course. We report such failure after 12 years, suggesting no safe period after which femoral implant fracture does not occur. PMID:26955493

  7. [Larynx: implants and stents].

    PubMed

    Sittel, C

    2009-05-01

    There is a wide variety of devices and materials to be implanted into the human larynx. Some are intended to remain only for a period of time, like laryngeal stents. If removal is not intended the device meets the definition for a medical implant. The majority of implants is used for the treatment of unilateral vocal fold immobility. There a 2 types of implants serving this purpose: Implants in a stricter sense are devices of solid material, which are brought into the paraglottic space through a window in the laryngeal framework (medialization thyroplasty). Several different products are presented in this review. In contrast, there are different substances available for endoscopic injection into the paralyzed vocal fold (injection laryngoplasty). Since some of these substances show a corpuscular consistency and a high viscosity they need to be deposited into the lateral paraglottic space. Therefore, the term "injectable implants" has been coined for these materials. The different substances available are discussed in detail in this review. Laryngeal stents are primarily used in the early postoperative phase after open reconstruction of the larynx. The different devices available on the market are described with their specific characteristics and intended use.

  8. Anodized dental implant surface.

    PubMed

    Mishra, Sunil Kumar; Kumar, Muktadar Anand; Chowdhary, Ramesh

    2017-01-01

    Anodized implants with moderately rough surface were introduced around 2000. Whether these implants enhanced biologic effect to improve the environment for better osseointegration was unclear. The purpose of this article was to review the literature available on anodized surface in terms of their clinical success rate and bone response in patients till now. A broad electronic search of MEDLINE and PubMed databases was performed. A focus was made on peer-reviewed dental journals. Only articles related to anodized implants were included. Both animal and human studies were included. The initial search of articles resulted in 581 articles on anodized implants. The initial screening of titles and abstracts resulted in 112 full-text papers; 40 animal studies, 16 studies on cell adhesion and bacterial adhesion onto anodized surfaced implants, and 47 human studies were included. Nine studies, which do not fulfill the inclusion criteria, were excluded. The long-term studies on anodized surface implants do favor the surface, but in most of the studies, anodized surface is compared with that of machined surface, but not with other surfaces commercially available. Anodized surface in terms of clinical success rate in cases of compromised bone and immediately extracted sockets has shown favorable success.

  9. Biocompatible implant surface treatments.

    PubMed

    Pattanaik, Bikash; Pawar, Sudhir; Pattanaik, Seema

    2012-01-01

    Surface plays a crucial role in biological interactions. Surface treatments have been applied to metallic biomaterials in order to improve their wear properties, corrosion resistance, and biocompatibility. A systematic review was performed on studies investigating the effects of implant surface treatments on biocompatibility. We searched the literature using PubMed, electronic databases from 1990 to 2009. Key words such as implant surface topography, surface roughness, surface treatment, surface characteristics, and surface coatings were used. The search was restricted to English language articles published from 1990 to December 2009. Additionally, a manual search in the major dental implant journals was performed. When considering studies, clinical studies were preferred followed by histological human studies, animal studies, and in vitro studies. A total of 115 articles were selected after elimination: clinical studies, 24; human histomorphometric studies, 11; animal histomorphometric studies, 46; in vitro studies, 34. The following observations were made in this review: · The focus has shifted from surface roughness to surface chemistry and a combination of chemical manipulations on the porous structure. More investigations are done regarding surface coatings. · Bone response to almost all the surface treatments was favorable. · Future trend is focused on the development of osteogenic implant surfaces. Limitation of this study is that we tried to give a broader overview related to implant surface treatments. It does not give any conclusion regarding the best biocompatible implant surface treatment investigated till date. Unfortunately, the eventually selected studies were too heterogeneous for inference of data.

  10. Contraceptive implants and lactation.

    PubMed

    Díaz, Soledad

    2002-01-01

    The safety and efficacy of four contraceptive implants, plant, Implanon, Nestorone and Elcometrine, have been evaluated during use in the postpartum period by lactating women. These implants provide highly effective contraceptive protection with no negative effect on breastfeeding or infant growth and development. Breastfeeding women initiating Norplant use in the second postpartum month experience significantly longer periods of amenorrhea than do untreated women or intrauterine device users. After weaning, the bleeding pattern is similar to that observed in non-nursing women. Norplant use does not affect bone turnover and density during lactation. Norplant and Implanon release orally active progestins while Nestorone and Elcometrine implants release an orally inactive progestin, which represents an advantage since the infant should be free of steroidal effects. The infant's daily intake of steroids (estimated from concentrations in maternal milk during the first month of use) range from 90 to 100 ng of levonorgestrel (Norplant), 75-120 ng of etonogestrel (Implanon), and 50 ng and 110 ng of Nestorone (Nestorone and Elcometrine implants, respectively). Nursing women needing contraception may use progestin-only implants when nonhormonal methods are not available or acceptable. Implants that deliver orally active steroids should only be used after 6 weeks postpartum to avoid transferring of steroids to the newborn.

  11. Simple Implant Augmentation Rhinoplasty

    PubMed Central

    Nguyen, Anh H.; Bartlett, Erica L.; Kania, Katarzyna; Bae, Sang Mo

    2015-01-01

    Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placement. An implant prosthesis should be used on a case-by-case basis. Augmentation rhinoplasty requires the consideration of specific anatomical preoperative factors, including the external nose, nasal length, nasofrontal angle, humps, and facial proportions. It is equally important to consider several operative guidelines to appropriately shape implants to minimize the occurrence of adverse effects and postoperative complications. The most common postoperative complications include infection, nasal height change, movement of implant prosthesis, and silicone implant protrusion. In addition, the surgeon should consider the current standards of Asian beauty aesthetics to better understand the patient's desired outcome. PMID:26648804

  12. Prosthetic resolution of peri-implant mucositis: promoting soft-tissue health through proper restorative design.

    PubMed

    Azar, David E

    2014-01-01

    As the use of dental implants has become more prevalent in restorative dentistry, a need has emerged for developing proper therapeutic approaches and modalities to treat peri-implant disease. While much attention has focused on tissue-centric treatment modalities, this article will examine another causative factor in peri-implant disease: improper restorative design. It will discuss the therapeutic benefits of modifying the morphology of existing restorative components in a case of chronic peri-implant mucositis, as well as review some basic concepts of current implant management.

  13. Short dental implants: an emerging concept in implant treatment.

    PubMed

    Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah

    2014-06-01

    Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.

  14. Brain components

    MedlinePlus Videos and Cool Tools

    The brain is composed of more than a thousand billion neurons. Specific groups of them, working in concert, provide ... of information. The 3 major components of the brain are the cerebrum, cerebellum, and brain stem. The ...

  15. MEMS-based power generation techniques for implantable biosensing applications.

    PubMed

    Lueke, Jonathan; Moussa, Walied A

    2011-01-01

    Implantable biosensing is attractive for both medical monitoring and diagnostic applications. It is possible to monitor phenomena such as physical loads on joints or implants, vital signs, or osseointegration in vivo and in real time. Microelectromechanical (MEMS)-based generation techniques can allow for the autonomous operation of implantable biosensors by generating electrical power to replace or supplement existing battery-based power systems. By supplementing existing battery-based power systems for implantable biosensors, the operational lifetime of the sensor is increased. In addition, the potential for a greater amount of available power allows additional components to be added to the biosensing module, such as computational and wireless and components, improving functionality and performance of the biosensor. Photovoltaic, thermovoltaic, micro fuel cell, electrostatic, electromagnetic, and piezoelectric based generation schemes are evaluated in this paper for applicability for implantable biosensing. MEMS-based generation techniques that harvest ambient energy, such as vibration, are much better suited for implantable biosensing applications than fuel-based approaches, producing up to milliwatts of electrical power. High power density MEMS-based approaches, such as piezoelectric and electromagnetic schemes, allow for supplemental and replacement power schemes for biosensing applications to improve device capabilities and performance. In addition, this may allow for the biosensor to be further miniaturized, reducing the need for relatively large batteries with respect to device size. This would cause the implanted biosensor to be less invasive, increasing the quality of care received by the patient.

  16. MEMS-Based Power Generation Techniques for Implantable Biosensing Applications

    PubMed Central

    Lueke, Jonathan; Moussa, Walied A.

    2011-01-01

    Implantable biosensing is attractive for both medical monitoring and diagnostic applications. It is possible to monitor phenomena such as physical loads on joints or implants, vital signs, or osseointegration in vivo and in real time. Microelectromechanical (MEMS)-based generation techniques can allow for the autonomous operation of implantable biosensors by generating electrical power to replace or supplement existing battery-based power systems. By supplementing existing battery-based power systems for implantable biosensors, the operational lifetime of the sensor is increased. In addition, the potential for a greater amount of available power allows additional components to be added to the biosensing module, such as computational and wireless and components, improving functionality and performance of the biosensor. Photovoltaic, thermovoltaic, micro fuel cell, electrostatic, electromagnetic, and piezoelectric based generation schemes are evaluated in this paper for applicability for implantable biosensing. MEMS-based generation techniques that harvest ambient energy, such as vibration, are much better suited for implantable biosensing applications than fuel-based approaches, producing up to milliwatts of electrical power. High power density MEMS-based approaches, such as piezoelectric and electromagnetic schemes, allow for supplemental and replacement power schemes for biosensing applications to improve device capabilities and performance. In addition, this may allow for the biosensor to be further miniaturized, reducing the need for relatively large batteries with respect to device size. This would cause the implanted biosensor to be less invasive, increasing the quality of care received by the patient. PMID:22319362

  17. Understanding music with cochlear implants.

    PubMed

    Bruns, Lisa; Mürbe, Dirk; Hahne, Anja

    2016-08-25

    Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building.

  18. Understanding music with cochlear implants

    PubMed Central

    Bruns, Lisa; Mürbe, Dirk; Hahne, Anja

    2016-01-01

    Direct stimulation of the auditory nerve via a Cochlear Implant (CI) enables profoundly hearing-impaired people to perceive sounds. Many CI users find language comprehension satisfactory, but music perception is generally considered difficult. However, music contains different dimensions which might be accessible in different ways. We aimed to highlight three main dimensions of music processing in CI users which rely on different processing mechanisms: (1) musical discrimination abilities, (2) access to meaning in music, and (3) subjective music appreciation. All three dimensions were investigated in two CI user groups (post- and prelingually deafened CI users, all implanted as adults) and a matched normal hearing control group. The meaning of music was studied by using event-related potentials (with the N400 component as marker) during a music-word priming task while music appreciation was gathered by a questionnaire. The results reveal a double dissociation between the three dimensions of music processing. Despite impaired discrimination abilities of both CI user groups compared to the control group, appreciation was reduced only in postlingual CI users. While musical meaning processing was restorable in postlingual CI users, as shown by a N400 effect, data of prelingual CI users lack the N400 effect and indicate previous dysfunctional concept building. PMID:27558546

  19. The vestibular implant: quo vadis?

    PubMed

    van de Berg, Raymond; Guinand, Nils; Stokroos, Robert J; Guyot, Jean-Philippe; Kingma, Herman

    2011-01-01

    To assess the progress of the development of the vestibular implant (VI) and its feasibility short-term. A search was performed in Pubmed, Medline, and Embase. Key words used were "vestibular prosth*" and "VI." The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation. All studies about the VI and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the VI. Data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. To use a basic VI in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation), complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt.

  20. The Vestibular Implant: Quo Vadis?

    PubMed Central

    van de Berg, Raymond; Guinand, Nils; Stokroos, Robert J.; Guyot, Jean-Philippe; Kingma, Herman

    2011-01-01

    Objective: To assess the progress of the development of the vestibular implant (VI) and its feasibility short-term. Data sources: A search was performed in Pubmed, Medline, and Embase. Key words used were “vestibular prosth*” and “VI.” The only search limit was language: English or Dutch. Additional sources were medical books, conference lectures and our personal experience with per-operative vestibular stimulation in patients selected for cochlear implantation. Study selection: All studies about the VI and related topics were included and evaluated by two reviewers. No study was excluded since every study investigated different aspects of the VI. Data extraction and synthesis: Data was extracted by the first author from selected reports, supplemented by additional information, medical books conference lectures. Since each study had its own point of interest with its own outcomes, it was not possible to compare data of different studies. Conclusion: To use a basic VI in humans seems feasible in the very near future. Investigations show that electric stimulation of the canal nerves induces a nystagmus which corresponds to the plane of the canal which is innervated by the stimulated nerve branch. The brain is able to adapt to a higher baseline stimulation, while still reacting on a dynamic component. The best response will be achieved by a combination of the optimal stimulus (stimulus profile, stimulus location, precompensation), complemented by central vestibular adaptation. The degree of response will probably vary between individuals, depending on pathology and their ability to adapt. PMID:21991260

  1. FBG applied in dynamic analysis of an implanted cadaveric mandible

    NASA Astrophysics Data System (ADS)

    Silva, Jean C. C.; Carvalho, Lidia; Nogueira, Rogerio N.; Simoes, Jose A.; Pinto, Joao L.; Kalinowski, Hypolito J.

    2004-06-01

    This work describes the use of a fiber Bragg grating sensor (FBG) to measure strains at a mandible surface caused by impact loads on a dental implant. The apparatus uses a tuneable optical filter reference scheme and is able to detect dynamic signals with frequency components up to 10 kHz. A dried cadaveric mandible with a dental implant, and a FBG placed on the outer surface was used. The results demonstrate the ability of the FBG as a biomechanical sensor.

  2. An evaluation of impression techniques for osseointegrated implants.

    PubMed

    Spector, M R; Donovan, T E; Nicholls, J I

    1990-04-01

    A passive fit between osseointegrated implants and the prosthesis they will support has been advocated. An experimental model was developed to test the accuracy of three impression techniques and the components used to make the transfer records. Statistically, no significant difference was found between the three methods tested. From this initial study, it appears that further work is needed to isolate techniques that will predictably provide accurate registration of the position of endosseous implants.

  3. Hybrid cathode lithium batteries for implantable medical applications

    NASA Astrophysics Data System (ADS)

    Chen, Kaimin; Merritt, Donald R.; Howard, William G.; Schmidt, Craig L.; Skarstad, Paul M.

    Lithium batteries with hybrid cathodes of Ag 2V 4O 11 and CF x have been developed that combine the best features of both cathode components. They can offer power density and energy density that are competitive with or superior to other developed battery chemistries, along with the stability and reliability needed for implantable medical applications. More than 100,000 have been used in human implants since introduction in 1999.

  4. Wireless Power Transfer Strategies for Implantable Bioelectronics: Methodological Review.

    PubMed

    Agarwal, Kush; Jegadeesan, Rangarajan; Guo, Yong-Xin; Thakor, Nitish V

    2017-03-16

    Neural implants have emerged over the last decade as highly effective solutions for the treatment of dysfunctions and disorders of the nervous system. These implants establish a direct, often bidirectional, interface to the nervous system, both sensing neural signals and providing therapeutic treatments. As a result of the technological progress and successful clinical demonstrations, completely implantable solutions have become a reality and are now commercially available for the treatment of various functional disorders. Central to this development is the wireless power transfer (WPT) that has enabled implantable medical devices (IMDs) to function for extended durations in mobile subjects. In this review, we present the theory, link design, and challenges, along with their probable solutions for the traditional near-field resonant inductively coupled WPT, capacitively coupled short ranged WPT, and more recently developed ultrasonic, mid-field and far-field coupled WPT technologies for implantable applications. A comparison of various power transfer methods, based on their power budgets and WPT range follows. Power requirements of specific implants like cochlear, retinal, cortical and peripheral are also considered and currently available IMD solutions are discussed. Patient's safety concerns with respect to electrical, biological, physical, electromagnetic interference and cyber security from an implanted neurotech device are also explored in this review. Finally, we discuss and anticipate future developments that will enhance the capabilities of current-day wirelessly powered implants and make them more efficient and integrable with other electronic components in IMDs.

  5. 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

  6. The Ultrastructural Relationship Between Osteocytes and Dental Implants Following Osseointegration.

    PubMed

    Du, Zhibin; Ivanovski, Saso; Hamlet, Stephen M; Feng, Jian Q; Xiao, Yin

    2016-04-01

    Osteocytes, the most abundant cells in bone, have multiple functions, including acting as mechanosensors and regulating mineralization. It is clear that osteocytes influence bone remodeling by controlling the differentiation and activity of osteoblasts and osteoclasts. Determining the relationship between titanium implants and osteocytes may therefore benefit our understanding of the process of osseointegration. The aim of this study was to visualize the ultrastructural relationship between osteocytes and the titanium implant surface following osseointegration in vivo. Titanium implants were placed in the maxillary molar regions of eight female Sprague Dawley rats, 3 months old. The animals were sacrificed 8 weeks after implantation, and undecalcified tissue sections were prepared. Resin-cast samples were subsequently acid-etched with 37% phosphoric acid prior to examination using scanning electron microscopy. Compared with mature bone, where the osteocytes were arranged in an ordered fashion, the osteocytes appeared less organized in the newly formed bone around the titanium implant. Further, a layer of mineralization with few organic components was observed on the implant surface. This study shows for the first time that osteocytes and their dendrites are directly connected with the implant surface. This study shows the direct anchorage of osteocytes via dendritic processes to a titanium implant surface in vivo. This suggests an important regulatory role for osteocytes and their lacunar-canalicular network in maintaining long-term osseointegration. © 2014 Wiley Periodicals, Inc.

  7. An Overview of the Mechanical Integrity of Dental Implants

    PubMed Central

    Shemtov-Yona, Keren; Rittel, Daniel

    2015-01-01

    With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance. PMID:26583117

  8. An Overview of the Mechanical Integrity of Dental Implants.

    PubMed

    Shemtov-Yona, Keren; Rittel, Daniel

    2015-01-01

    With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance.

  9. Soft Tissue Surgical Procedures for Optimizing Anterior Implant Esthetics.

    PubMed

    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.

  10. [Dental implant-related infections].

    PubMed

    López-Cerero, Lorena

    2008-11-01

    Dental implant-associated infections are expected to be increasingly more common as the number of patients with implants for more than 10 years rises. There are 2 stages of peri-implant infection: early mucositis, consisting of inflammation of the peri-implant soft tissues without loss of supporting bone, and a more advanced form involving a loss of osseointegration, known as peri-implantitis. The estimated prevalence of this latter infection is 10% of 5-year implants and the main risk factor is previous periodontal disease. The etiopathogenesis of peri-implantitis is related with reservoirs of periodontal pathogens; however factors that lead to colonization of the implant surface or increased susceptibility to infection may also have an influence. Treatment should include removal of the bacterial biofilm, debridement of the exposed surface, and surgical regeneration of the peri-implant pocket.

  11. Basic design and construction of the Vienna FES implants: existing solutions and prospects for new generations of implants.

    PubMed

    Mayr, W; Bijak, M; Rafolt, D; Sauermann, S; Unger, E; Lanmüller, H

    2001-01-01

    We can distinguish 3 generations of FES implants for activation of neural structures: 1. RF-powered implants with antenna displacement dependent stimulation amplitude; 2. RF-powered implants with stabilised stimulation amplitude; and 3. battery powered implants. In Vienna an 8-channel version of the second generation type has been applied clinically to mobilisation of paraplegics and phrenic pacing. A 20-channel implant of the second generation type for mobilisation of paraplegics and an 8-channel implant of the third generation type for cardiac assist have been tested in animal studies. A device of completely new design for direct stimulation of denervated muscles is being tested in animal studies. There is a limited choice of technologically suitable biocompatible and bioresistant materials for implants. The physical design has to be anatomically shaped without corners or edges. Electrical conductors carrying direct current (D.C.) have to be placed inside a hermetic metal case. The established sealing materials, silicone rubber and epoxy resin, do not provide hermeticity and should only embed DC-free components. For electrical connections outside the hermetic metal case welding is preferable to soldering; conductive adhesives should be avoided. It is advisable to use a hydrophobic oxide ceramic core for telemetry antenna coils embedded in sealing polymer. Cleaning of all components before sealing in resin is of the utmost importance as well as avoidance of rapid temperature changes during the curing process.

  12. Ion Implanted Gaas Integrated Optics Fabrication Technology

    NASA Astrophysics Data System (ADS)

    Mentzer, M. A.; Hunsperger, R. G.; Bartko, J.; Zavada, J. M.; Jenkinson, H. A.

    1985-01-01

    Ion implantation of semiconductor materials is a fabrication technique that offers a number of distinct advantages for the formation of guided-wave components and microelectronic devices. Implanted damage and dopants produce optical and electronic changes that can be utilized for sensing and signal processing applications. GaAs is a very attractive material for optical fabrication since it is transparent out to the far infrared. It can be used to fabricate optical waveguides, directional couplers, EO modulators, and detectors, as well as other guided wave structures. The presence of free carriers in GaAs lowers the refractive index from that of the pure semiconductor material. This depression of the refractive index is primarily due to the negative contribution of the free carrier plasma to the dielectric constant of the semiconductor. Bombardment of n-type GaAs by protons creates damage sites near the surface of the crystal structure where free carriers are trapped. This "free carrier compensated" region in the GaAs has a higher refractive index than the bulk region. If the compensated region is sufficiently thick and has a refractive index which is sufficiently larger than that of the bulk n-type region, an optical waveguide is formed. In this paper, a description of ion implantation techniques for the fabrication of both planar and channel integrated optical structures in GaAs is presented, and is related to the selection of ion species, implant energy and fluence, and to the physical processes involved. Lithographic technology and masking techniques are discussed for achieving a particular desired implant profile. Finally, the results of a set of ion implantation experiments are presented.

  13. The pathobiology and pathology of aseptic implant failure

    PubMed Central

    2016-01-01

    Pathological assessment of periprosthetic tissues is important, not only for diagnosis, but also for understanding the pathobiology of implant failure. The host response to wear particle deposition in periprosthetic tissues is characterised by cell and tissue injury, and a reparative and inflammatory response in which there is an innate and adaptive immune response to the material components of implant wear. Physical and chemical characteristics of implant wear influence the nature of the response in periprosthetic tissues and account for the development of particular complications that lead to implant failure, such as osteolysis which leads to aseptic loosening, and soft-tissue necrosis/inflammation, which can result in pseudotumour formation. The innate response involves phagocytosis of implant-derived wear particles by macrophages; this is determined by pattern recognition receptors and results in expression of cytokines, chemokines and growth factors promoting inflammation and osteoclastogenesis; phagocytosed particles can also be cytotoxic and cause cell and tissue necrosis. The adaptive immune response to wear debris is characterised by the presence of lymphoid cells and most likely occurs as a result of a cell-mediated hypersensitivity reaction to cell and tissue components altered by interaction with the material components of particulate wear, particularly metal ions released from cobalt-chrome wear particles. Cite this article: Professor N. A. Athanasou. The pathobiology and pathology of aseptic implant failure. Bone Joint Res 2016;5:162–168. DOI: 10.1302/2046-3758.55.BJR-2016-0086. PMID:27146314

  14. Positron implantation in solids

    SciTech Connect

    Ghosh, V.J.; Lynn, K.G.; Welch, D.O.

    1993-12-31

    The Monte Carlo technique for modeling positron prior to annihilation and electron implantation in semi-infinite metals is described. Particle implantation is modelled as a multistep process, a series of collisions with the atoms of the host material. In elastic collisions with neutral atoms there is no transfer of energy. The particle loses energy by several different channels, excitation of the electron gas, ionization of the ion cores, or, at low energies, by phonon excitation. These competing scattering mechanisms have been incorporated into the Monte Carlo framework and several different models are being used. Brief descriptions of these Monte Carlo schemes, as well as an analytic model for positron implantation are included. Results of the Monte Carlo simulations are presented and compared with expermental data. Problems associated with modeling positron implantation are discuss and the need for more expermental data on energy-loss in different materials is stressed. Positron implantation in multilayers of different metals is briefly described and extensions of this work to include a study of multilayers and heterostructures is suggested.

  15. [Cochlear implant in children: rational, indications and cost/efficacy].

    PubMed

    Martini, A; Bovo, R; Trevisi, P; Forli, F; Berrettini, S

    2013-06-01

    A cochlear implant (CI) is a partially implanted electronic device that can help to provide a sense of sound and support speech to severely to profoundly hearing impaired patients. It is constituted by an external portion, that usually sits behind the ear and an internal portion surgically placed under the skin. The external components include a microphone connected to a speech processor that selects and arranges sounds pucked up by the microphone. This is connected to a transmitter coil, worn on the side of the head, which transmits data to an internal receiver coil placed under the skin. The received data are delivered to an array of electrodes that are surgically implanted within the cochlea. The primary neural targets of the electrodes are the spiral ganglion cells which innervate fibers of the auditory nerve. When the electrodes are activated by the signal, they send a current along the auditory nerve and auditory pathways to the auditory cortex. Children and adults who are profoundly or severely hearing impaired can be fitted with cochlear implants. According to the Food and Drug Administration, approximately 188,000 people worldwide have received implants. In Italy it is extimated that there are about 6-7000 implanted patients, with an average of 700 CI surgeries per year. Cochlear implantation, followed by intensive postimplantation speech therapy, can help young children to acquire speech, language, and social skills. Early implantation provides exposure to sounds that can be helpful during the critical period when children learn speech and language skills. In 2000, the Food and Drug Administration lowered the age of eligibility to 12 months for one type of CI. With regard to the results after cochlear implantation in relation to early implantation, better linguistic results are reported in children implanted before 12 months of life, even if no sufficient data exist regarding the relation between this advantage and the duration of implant use and how long

  16. Extraoral prostheses using extraoral implants.

    PubMed

    Pekkan, G; Tuna, S H; Oghan, F

    2011-04-01

    The aim of this study was to evaluate extraoral prostheses and the use of extraoral implants in patients with facial defects. 10 cases were treated utilizing maxillofacial prostheses employing extraoral implants in five cases. 16 extraoral implants were installed. Seven implants were placed in irradiated sites in the orbital regions. Six implants were placed in mastoid regions and three in a zygoma region that was irradiated. Two implants failed before initial integration was achieved in irradiated areas. Using 14 extraoral implants as anchors, five extraoral prostheses were set. The other five cases were treated with extraoral prostheses without using extraoral implants due to cost and patient-related factors. The data included age, sex, primary disease, implant length, implant failure, prosthetic attachment, radiation therapy, and peri-implant skin reactions. The use of extraoral implants for the retention of extraoral prostheses has simplified the placement, removal, and cleaning of the prosthesis by the patient. The stability of the prostheses was improved by anchors. Clinical and technical problems are presented with the techniques used for their resolution. Using extraoral implants resulted in a high rate of success in retaining facial prostheses and gave good stability and aesthetic satisfaction.

  17. Management of peri-implantitis

    PubMed Central

    Prathapachandran, Jayachandran; Suresh, Neethu

    2012-01-01

    Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an osseointegrated implant in function. The etiology of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless the origin is the result of simple mechanical overload. Diagnosis is based on changes of color in the gingiva, bleeding and probing depth of peri-implant pockets, suppuration, X-ray, and gradual loss of bone height around the tooth. Treatment will differ depending upon whether it is a case of peri-implant mucositis or peri-implantitis. The management of implant infection should be focused on the control of infection, the detoxification of the implant surface, and regeneration of the alveolar bone. This review article deals with the various treatment options in the management of peri-implantitis. The article also gives a brief description of the etiopathogenesis, clinical features, and diagnosis of peri-implantitis. PMID:23559913

  18. Battery component

    SciTech Connect

    Goebel, F.; Batson, D.C.; Miserendino, A.J.; Boyle, G.

    1988-03-15

    A mechanical component for reserve type electrochemical batteries having cylindrical porous members is described comprising a disc having: (i) circular grooves in one flat side for accepting the porous members; and (ii) at least one radial channel in the opposite flat side in fluid communication with the grooves.

  19. Lightweight Breast Implants: A Novel Solution for Breast Augmentation and Reconstruction Mammaplasty

    PubMed Central

    Govrin-Yehudain, Jacky; Dvir, Haim; Preise, Dina; Govrin-Yehudain, Orel; Govreen-Segal, Dael

    2015-01-01

    Breast augmentation and reconstruction mammaplasty have been in practice for decades and are highly prevalent surgeries performed worldwide. While overall patient satisfaction is high, common long-term effects include breast tissue atrophy, accelerated ptosis and inframammary fold breakdown. Increasing evidence attributes these events to the durative loading and compressive forces introduced by the breast implants. Mechanical challenges exceeding the elastic capacity of the breast tissue components, eventually lead to irreversible tissue stretching, directly proportional to the introduced mass. Thus, it is suggested that, contrary to long-standing dogmas, implant weight, rather than its volume, stands at the basis of future tissue compromise and deformation. A novel lightweight implant has been developed to address the drawbacks of traditional breast implants, which demonstrate equivalence between their size and weight. The B-Lite® breast implant (G&G Biotechnology Ltd., Haifa, Israel) design allows for a reduction in implant weight of up to 30%, while maintaining the size, form, and function of traditional breast implants. The CE-marked device can be effectively implanted using standard of care procedures and has been established safe for human use. Implantation of the B-Lite® breast implant is projected to significantly reduce the inherent strains imposed by standard implants, thereby conserving tissue stability and integrity over time. In summary, this novel, lightweight breast implant promises to reduce breast tissue compromise and deformation and subsequent reoperation, further improving patient safety and satisfaction. PMID:26333989

  20. Dental implants: A review.

    PubMed

    Guillaume, B

    2016-12-01

    A high number of patients have one or more missing tooth and it is estimated that one in four American subjects over the age of 74 have lost all their natural teeth. Many options exist to replace missing teeth but dental implants have become one of the most used biomaterial to replace one (or more) missing tooth over the last decades. Contemporary dental implants made with titanium have been proven safe and effective in large series of patients. This review considers the main historical facts concerned with dental implants and present the different critical factors that will ensure a good osseo-integration that will ensure a stable prosthesis anchorage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Complications in implant dentistry

    PubMed Central

    Hanif, Ayesha; Qureshi, Saima; Sheikh, Zeeshan; Rashid, Haroon

    2017-01-01

    After tooth loss, an individual may seek tooth replacement so that his/her function and esthetics could be restored. Clinical prosthodontics, during the past decade, has significantly improved and developed according to the advancements in the science and patient's demands and needs. Conventional options in prosthodontics for substituting a missing single tooth include the removable partial denture, partial and full coverage bridgework, and resin-bonded bridgework. Dental implants have gained increasing popularity over the years as they are capable of restoring the function to near normal in both partial and completely edentulous arches. With substantial evidence available, fixed implant-supported prosthesis are fully acknowledged as a reliable treatment option for the replacement of single or multiple missing teeth nowadays. While dental implants are increasingly becoming the choice of replacement for missing teeth, the impediments associated with them are progressively emerging too. PMID:28435381

  2. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

  3. Current trends in dental implants

    PubMed Central

    Gaviria, Laura; Salcido, John Paul; Guda, Teja

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants. PMID:24868501

  4. Biofilm related to dental implants.

    PubMed

    Lee, Angie; Wang, Hom-Lay

    2010-10-01

    Oral biofilm-related diseases such as periodontal and peri-implant diseases are unique infections in that they develop from the resident indigenous microflora. As more implants are nowadays being placed, clinicians may encounter more complications. Therefore, understanding the etiology is warranted to establish adequate diagnosis and provide proper treatment. This article focuses on understanding peri-implant microbiology and its roles in peri-implant diseases.

  5. Hyperfrequency components

    NASA Astrophysics Data System (ADS)

    1994-09-01

    The document has a collection of 19 papers (11 on technologies, 8 on applications) by 26 authors and coauthors. Technological topics include: evolution from conventional HEMT's double heterojunction and planar types of pseudomorphic HEMT's; MMIC R&D and production aspects for very-low-noise, low-power, and very-low-noise, high-power applications; hyperfrequency CAD tools; parametric measurements of hyperfrequency components on plug-in cards for design and in-process testing uses; design of Class B power amplifiers and millimetric-wave, bigrid-transistor mixers, exemplifying combined use of three major types of physical simulation in electrical modeling of microwave components; FET's for power amplification at up to 110 GHz; production, characterization, and nonlinear applications of resonant tunnel diodes. Applications topics include: development of active modules for major European programs; tubes versus solid-state components in hyperfrequency applications; status and potentialities of national and international cooperative R&D on MMIC's and CAD of hyperfrequency circuitry; attainable performance levels in multifunction MMIC applications; state of the art relative of MESFET power amplifiers (Bands S, C, X, Ku); creating a hyperfrequency functions library, of parametrizable reference cells or macrocells; and design of a single-stage, low-noise, band-W amplifier toward development of a three-stage amplifier.

  6. Component separations.

    PubMed

    Heller, Lior; McNichols, Colton H; Ramirez, Oscar M

    2012-02-01

    Component separation is a technique used to provide adequate coverage for midline abdominal wall defects such as a large ventral hernia. This surgical technique is based on subcutaneous lateral dissection, fasciotomy lateral to the rectus abdominis muscle, and dissection on the plane between external and internal oblique muscles with medial advancement of the block that includes the rectus muscle and its fascia. This release allows for medial advancement of the fascia and closure of up to 20-cm wide defects in the midline area. Since its original description, components separation technique underwent multiple modifications with the ultimate goal to decrease the morbidity associated with the traditional procedure. The extensive subcutaneous lateral dissection had been associated with ischemia of the midline skin edges, wound dehiscence, infection, and seroma. Although the current trend is to proceed with minimally invasive component separation and to reinforce the fascia with mesh, the basic principles of the techniques as described by Ramirez et al in 1990 have not changed over the years. Surgeons who deal with the management of abdominal wall defects are highly encouraged to include this technique in their collection of treatment options.

  7. The silicone breast implant controversy.

    PubMed

    Guerette, P H

    1995-02-01

    Feminists call it objectification. Consumer advocates call it victimization. Medical personnel call it augmentation. Women, implantation. Whatever the term, media hype and the increasing number of lawsuits against U.S. manufacturers of silicone breast implants has caused widespread concern among women and raised serious questions about the long term health risks and safety of breast implant devices.

  8. Sterilisation of bioresorbable polymer implants.

    PubMed

    Bernkopf, M

    2007-01-01

    Bioresorbable polymer implants are rapidly growing alternatives to traditional implants in many applications. Because of their resorption in the body, it is necessary to sterilise the complete product before application. The suitability of different sterilisation methods for bioresorbable polymers is discussed using polylactic acid implants as an example.

  9. Treatment of peri-implantitis and the failing implant.

    PubMed

    Robertson, Kevin; Shahbazian, Timothy; MacLeod, Stephen

    2015-04-01

    Appropriate treatment of implants is becoming increasingly important for the general dentist as the number of implants placed per year continues to increase. Early diagnosis of peri-implantitis is imperative; initiating the correct treatment protocol depends on a proper diagnosis. Several risk factors exist for the development of peri-implantitis, which can guide patient selection and treatment planning. Treatment of peri-implantitis should be tailored to the severity of the lesion (as outlined by the cumulative interceptive supportive treatment protocol), ranging from mechanical debridement to explantation. Several surgical and nonsurgical treatment alternatives exist. There is little consensus on superior treatment methods. Published by Elsevier Inc.

  10. Two-stage implant systems.

    PubMed

    Fritz, M E

    1999-06-01

    Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

  11. Implant contamination during spine surgery.

    PubMed

    Bible, Jesse E; O'Neill, Kevin R; Crosby, Colin G; Schoenecker, Jonathan G; McGirt, Matthew J; Devin, Clinton J

    2013-06-01

    Postoperative spine infections have been reported to occur in 1% to 15% of patients and subsequently lead to significant morbidity and cost, with an elevated risk for instrumented cases. Every effort should be made to minimize the risk of intraoperative wound contamination. Consequently, certain practices are followed in the operating room to prevent contamination, many of which are not evidence based. Conversely, certain objects believed to be sterile are frequently overlooked as potential sources of contamination. To assess to what degree contamination of spinal implants occurs during spine surgery and evaluate whether coverage of implants alters the rate of contamination. Prospective study. This study included 105 consecutive noninfection surgical cases performed by a single spine surgeon that required the use of instrumentation. Spinal implant contamination. Cases were randomized to have all implant trays either remain uncovered (n=54) or covered (n=51) with sterile surgical towels on opening until implants were required for the case. After the last implant was placed, a sterile culture swab was used to obtain a sample from all open implants that had been present at the start of the case. The paper outer wraps of the implant trays were sampled in each case as a positive control, and an additional 105 swabs were capped immediately after they were opened to obtain negative controls. Swab samples were assessed for bacterial growth on 5% sheep blood Columbia agar plates. Of note, only departmental funding was used and no applicable financial relationships exist with any author. No growth was observed on any of the 105 negative controls, whereas 99.1% of positive controls demonstrated obvious contamination. Cultures from implant samples demonstrated a 9.5% overall rate of contamination with 2.0% (n=1) of covered implants versus 16.7% (n=9) of uncovered implants demonstrating contamination. Length of time implant trays were open before sample collection; implant type

  12. Remote actuated valve implant

    DOEpatents

    McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

    2014-02-25

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  13. Remote actuated valve implant

    DOEpatents

    McKnight, Timothy E.; Johnson, Anthony; Moise, Kenneth J.; Ericson, Milton Nance; Baba, Justin S.; Wilgen, John B.; Evans, Boyd Mccutchen

    2016-05-10

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  14. Implantable electrical device

    NASA Technical Reports Server (NTRS)

    Jhabvala, M. D. (Inventor)

    1982-01-01

    A fully implantable and self contained device is disclosed composed of a flexible electrode array for surrounding damaged nerves and a signal generator for driving the electrode array with periodic electrical impulses of nanoampere magnitude to induce regeneration of the damaged nerves.

  15. Semiconductor Ion Implanters

    SciTech Connect

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at $7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at $6.2 billion. Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing 'only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around $2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  16. Implantable continuous glucose sensors.

    PubMed

    Renard, Eric

    2008-08-01

    Because of the limits of wearable needle-type or microdialysis-based enzymatic sensors in clinical use, fully implantable glucose monitoring systems (IGMS) represent a promising alternative. Long-term use reducing impact of invasiveness due to implantation, less frequent calibration needs because of a more stable tissue environment around the sensor and potential easier inclusion in a closed-loop insulin delivery system are the expected benefits of IGMS. First experiences with subcutaneous and intravenous IGMS have been recently collected in pilot studies. While no severe adverse events have been reported, biointerface issues have been responsible for the failures of IGMS. Tissue reactions around implanted subcutaneous devices and damages of intravenous sensors due to shearing forces of blood flow impaired IGMS function and longevity. In functioning systems, accuracy of glucose measurement reached satisfactory levels for average durations of about 120 days with subcutaneous IGMS and 259 days with intravenous sensors. Moreover, sensor information could help to improve time spent in normal glucose range when provided to patients wearing subcutaneous IGMS and allowed safe and effective closed-loop glucose control when intravenous sensors were connected to implanted pumps using intra-peritoneal insulin delivery. These data could open a favourable perspective for IGMS after improvement of biointerface conditions and if compatible with an affordable cost.

  17. Cochlear Implantation in Neurobrucellosis

    PubMed Central

    Bajin, Münir Demir; Savaş, Özden; Aslan, Filiz; Sennaroğlu, Levent

    2016-01-01

    Background: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation. Case Report: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members’ statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving. Conclusion: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results. PMID:26966626

  18. Practicing implant dentistry profitably.

    PubMed

    Stump, G; Adams, M; Alwan, M

    1997-03-01

    The success of dental implants has opened up countless treatment possibilities for restorative dentists to offer to their patients. Just as our clinical paradigms have had to change because of this new technology, so too must our paradigms concerning the way we communicate with our patients change if we are to get them to say "yes" to treatment that we know that they need. Success in clinical treatment using implants requires a systematic approach. A systematic approach to communicating with your patients will allow you to have the same high degree of success with treatment acceptance that is possible with dental implants. The key to the systems we have discussed is Relationship Centered Care. A relationship is fostered and enhanced through a Comprehensive Examination Process, a structured Consultation Process utilizing the influencing process and Financial Arrangements that allow the patient to receive what they want while the office maintains the profitability that it needs. A system for calculating rational fees can be utilized that allows the practice to have control over an area that traditionally was controlled by anecdotal factors. The Pride Institute has developed this material and is presenting it to the profession so that restorative dentists can truly practice implant dentistry profitably.

  19. Implantable Drug Dispenser

    NASA Technical Reports Server (NTRS)

    Collins, E. R. J.

    1983-01-01

    Drugs such as insulin are injected as needed directly into bloodstream by compact implantable dispensing unit. Two vapor cavities produce opposing forces on drug-chamber diaphragm. Heaters in cavities allow control of direction and rate of motion of bellows. Dispensing capsule fitted with coil so batteries can be recharged by induction.

  20. Implantable Drug Dispenser

    NASA Technical Reports Server (NTRS)

    Collins, E. R. J.

    1983-01-01

    Drugs such as insulin are injected as needed directly into bloodstream by compact implantable dispensing unit. Two vapor cavities produce opposing forces on drug-chamber diaphragm. Heaters in cavities allow control of direction and rate of motion of bellows. Dispensing capsule fitted with coil so batteries can be recharged by induction.

  1. Implantable Impedance Plethysmography

    PubMed Central

    Theodor, Michael; Ruh, Dominic; Ocker, Martin; Spether, Dominik; Förster, Katharina; Heilmann, Claudia; Beyersdorf, Friedhelm; Manoli, Yiannos; Zappe, Hans; Seifert, Andreas

    2014-01-01

    We demonstrate by theory, as well as by ex vivo and in vivo measurements that impedance plethysmography, applied extravascularly directly on large arteries, is a viable method for monitoring various cardiovascular parameters, such as blood pressure, with high accuracy. The sensor is designed as an implant to monitor cardiac events and arteriosclerotic progression over the long term. PMID:25123467

  2. Semiconductor Ion Implanters

    NASA Astrophysics Data System (ADS)

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at 7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at 6.2 billion! Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing `only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around 2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  3. Modification of polyvinyl alcohol surface properties by ion implantation

    NASA Astrophysics Data System (ADS)

    Pukhova, I. V.; Kurzina, I. A.; Savkin, K. P.; Laput, O. A.; Oks, E. M.

    2017-05-01

    We describe our investigations of the surface physicochemical properties of polyvinyl alcohol modified by silver, argon and carbon ion implantation to doses of 1 × 1014, 1 × 1015 and 1 × 1016 ion/cm2 and energies of 20 keV (for C and Ar) and 40 keV (for Ag). Infrared spectroscopy (IRS) indicates that destructive processes accompanied by chemical bond (sbnd Cdbnd O) generation are induced by implantation, and X-ray photoelectron spectroscopy (XPS) analysis indicates that the implanted silver is in a metallic Ag3d state without stable chemical bond formation with polymer chains. Ion implantation is found to affect the surface energy: the polar component increases while the dispersion part decreases with increasing implantation dose. Surface roughness is greater after ion implantation and the hydrophobicity increases with increasing dose, for all ion species. We find that ion implantation of Ag, Ar and C leads to a reduction in the polymer microhardness by a factor of five, while the surface electrical resistivity declines modestly.

  4. Successful Implantation of Bioengineered, Intrinsically Innervated, Human Internal Anal Sphincter

    PubMed Central

    Raghavan, Shreya; Gilmont, Robert R.; Miyasaka, Eiichi A.; Somara, Sita; Srinivasan, Shanthi; Teitelbaum, Daniel H; Bitar, Khalil N.

    2011-01-01

    Background & Aims To restore fecal continence, the weakened pressure of the internal anal sphincter (IAS) must be increased. We bioengineered intrinsically innervated human IAS, to emulate sphincteric physiology, in vitro. Methods We co-cultured human IAS circular smooth muscle with immortomouse fetal enteric neurons. We investigated the ability of bioengineered innervated human IAS, implanted in RAG1−/− mice, to undergo neovascularization and preserve the physiology of the constituent myogenic and neuronal components. Results The implanted IAS was neovascularized in vivo; numerous blood vessels were observed with no signs of inflammation or infection. Real-time force acquisition from implanted and pre-implant IAS showed distinct characteristics of IAS physiology. Features included the development of spontaneous myogenic basal tone; relaxation of 100% of basal tone in response to inhibitory neurotransmitter vasoactive intestinal peptide (VIP) and direct electrical field stimulation of the intrinsic innervation; inhibition of nitrergic and VIPergic EFS-induced relaxation (by antagonizing nitric oxide synthesis or receptor interaction); contraction in response to cholinergic stimulation with acetylcholine; and intact electromechanical coupling (evidenced by direct response to potassium chloride). Implanted, intrinsically innervated bioengineered human IAS tissue preserved the integrity and physiology of myogenic and neuronal components. Conclusion Intrinsically innervated human IAS bioengineered tissue can be successfully implanted in mice. This approach might be used to treat patients with fecal incontinence. PMID:21463628

  5. Effect of implant design on initial stability of tapered implants.

    PubMed

    Chong, Linus; Khocht, Ahmed; Suzuki, Jon B; Gaughan, John

    2009-01-01

    Implant design is one of the parameters for achieving successful primary stability. This study aims to examine the effect of a self-tapping blades implant design on initial stability in tapered implants. Polyurethane blocks of different densities were used to simulate different bone densities. The two different implant designs included one with self-tapping blades and one without self-tapping blades. Implants were placed at 3 different depths: apical third, middle third, and fully inserted at 3 different densities of polyurethane blocks. A resonance frequency (RF) analyzer was then used to measure stability of the implants. Repeated-measures analysis of variance was used to examine the effect of implant design, insertion depth, and block density on RF. Analysis of covariance was used to examine the strength of association between RF and the aforementioned factors. In both medium-density (P = .017) and high-density (P = .002) blocks, fully inserted non-self-tapping implants showed higher initial stability than self-tapping implants. No differences were noted between the 2 implant designs that were not fully inserted. The highest strength of association was with insertion depth (standardized beta [std beta] = -0.60, P = .0001), followed by block density (std beta = -0.15, P = .0002). Implant design showed a weak association (std beta = -0.07, P = .09). In conclusion, fully inserted implants without self-tapping blades have higher initial stability than implants with self-tapping blades. However, the association strength between implant design and initial stability is less relevant than other factors, such as insertion depth and block density. Thus, if bone quality and quantity are optimal, they may compensate for design inadequacy.

  6. Bone ingrowth in well-fixed retrieved porous tantalum implants.

    PubMed

    Hanzlik, Josa A; Day, Judd S

    2013-06-01

    While first generation porous coatings have had clinical success, aseptic loosening remains a leading cause of revision. The purpose of this study was to investigate the reasons for revision and to assess the amount of bone ingrowth in retrieved porous tantalum components. In a prospective multicenter retrieval program, 76 porous tantalum acetabular shells, 5 femoral stems, 7 patellas and 36 tibial trays were collected from revision surgeries. A subset of the implants was analyzed for bone ingrowth. The main reason for revision was infection for acetabular shells (1.4 years implantation time) and instability for tibial trays (1.8 years implantation time). Two of the thirty primary surgery acetabular shells and one of the thirty-six primary surgery tibial trays were revised for implant loosening. We observed full depth penetration of bone into the porous tantalum layer for the acetabular shells and femoral stems.

  7. Using flaw implants to qualify nuclear NDE personnel

    SciTech Connect

    Pherigo, G.L.; Pherigo, A.L.

    1994-12-31

    Intentionally flawed piping and vessel specimens are now required to simulate potential flawed conditions in nuclear power plants. These specimens will be used in a practical examination ``Performance Demonstration`` to verify the capabilities of ultrasonic testing (UT) personnel, procedures and equipment. ASME Section 11, Appendix 8, ``Performance Demonstration for Ultrasonic Examination Systems,`` was introduced into the Code to help substantiate the capability of NDE to detect and size flaws in nuclear power plant components. This paper is a brief discussion of some of the current methods used to implant flaws and will describe and evaluate the manufacturing techniques used to implant thermal fatigue cracks in stainless steel pipe and carbon steel vessel material. The accurate placement of flaw implants is critical and this paper will describe in some detail the tolerances applied to the flaw implant technology.

  8. Polymeric Packaging for Fully Implantable Wireless Neural Microsensors

    PubMed Central

    Aceros, Juan; Yin, Ming; Borton, David A.; Patterson, William R.; Bull, Christopher; Nurmikko, Arto V.

    2014-01-01

    We present polymeric packaging methods used for subcutaneous, fully implantable, broadband, and wireless neurosensors. A new tool for accelerated testing and characterization of biocompatible polymeric packaging materials and processes is described along with specialized test units to simulate our fully implantable neurosensor components, materials and fabrication processes. A brief description of the implantable systems is presented along with their current encapsulation methods based on polydimethylsiloxane (PDMS). Results from in-vivo testing of multiple implanted neurosensors in swine and non-human primates are presented. Finally, a novel augmenting polymer thin film material to complement the currently employed PDMS is introduced. This thin layer coating material is based on the Plasma Enhanced Chemical Vapor Deposition (PECVD) process of Hexamethyldisiloxane (HMDSO) and Oxygen (O2). PMID:23365999

  9. Polymeric packaging for fully implantable wireless neural microsensors.

    PubMed

    Aceros, Juan; Yin, Ming; Borton, David A; Patterson, William R; Bull, Christopher; Nurmikko, Arto V

    2012-01-01

    We present polymeric packaging methods used for subcutaneous, fully implantable, broadband, and wireless neurosensors. A new tool for accelerated testing and characterization of biocompatible polymeric packaging materials and processes is described along with specialized test units to simulate our fully implantable neurosensor components, materials and fabrication processes. A brief description of the implantable systems is presented along with their current encapsulation methods based on polydimethylsiloxane (PDMS). Results from in-vivo testing of multiple implanted neurosensors in swine and non-human primates are presented. Finally, a novel augmenting polymer thin film material to complement the currently employed PDMS is introduced. This thin layer coating material is based on the Plasma Enhanced Chemical Vapor Deposition (PECVD) process of Hexamethyldisiloxane (HMDSO) and Oxygen (O(2)).

  10. Bone Ingrowth in Well-Fixed Retrieved Porous Tantalum Implants

    PubMed Central

    Hanzlik, Josa A.; Day, Judd S.

    2013-01-01

    While first generation porous coatings have had clinical success, aseptic loosening remains a leading cause of revision. The purpose of this study was to investigate the reason for revision and to assess the amount of bone ingrowth in retrieved porous tantalum components. In a prospective multicenter retrieval program, 76 porous tantalum acetabular shells, 5 femoral stems, 7 patellas and 36 tibial trays were collected from revision surgeries. A subset of the implants were analyzed for bone ingrowth. The main reason for revision was infection for acetabular shells (1.4 year implantation time) and instability for tibial trays (1.8 years implantation time). Two of the thirty primary surgery acetabular shells and one of the thirty-six primary surgery tibial trays were revised for implant loosening. We observed full depth penetration of bone into the porous tantalum layer for the acetabular shells and femoral stems. PMID:23518432

  11. Analysis and management of implant-prosthetic complications: Description of a diagnostic and therapeutic algorithm with a clinical case.

    PubMed

    De Marco, Gennaro; Di Francesco, Fabrizio; Lanza, Alessandro

    2017-08-24

    A 65-year-old non-smoker man with stabilized chronic periodontitis and in good general health conditions presented to our observation. The patient reported crown mobility, gingival inflammation and localized pain, corresponding to the mandibular right first molar rehabilitated with a cement-retained implant crown. This clinical situation suspected a fracture of an implant-prosthetic component. Through the described diagnostic algorithm, an abutment hexagon fracture was revealed. Thus, a minimally invasive treatment was carried out in order to use the residual implant-prosthetic components for a new implant-prosthetic rehabilitation. Fractures of implant-prosthetic components are clinical occurrences that may result in irreversible failures. The main causes of a possible fracture are dependent on biomechanical considerations and production processes of implant-prosthetic components. The respect of the rigorous planning and the employment of the implant-prosthetic devices of the same manufacturer are recommended. Specific employments and protocols have to be offered in order to manage the fractures of implant-prosthetic components. This work showed that through the described diagnostic and therapeutic algorithm, the clinician can be guided towards a proper diagnosis and a correct management of the cases where a fracture of implant-prosthetic components may occur. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  12. Leakage of Microbial Endotoxin through the Implant-Abutment Interface in Oral Implants: An In Vitro Study.

    PubMed

    Garrana, Rhoodie; Mohangi, Govindrau; Malo, Paulo; Nobre, Miguel

    2016-01-01

    Background. Endotoxin initiates osteoclastic activity resulting in bone loss. Endotoxin leakage through implant abutment connections negatively influences peri-implant bone levels. Objectives. (i) To determine if endotoxin can traverse different implant-abutment connection (IAC) designs; (ii) to quantify the amount of endotoxins traversing the IAC; (iii) to compare the in vitro comportments of different IACs. Materials and Methods. Twenty-seven IACs were inoculated with E. coli endotoxin. Six of the twenty-seven IACs were external connections from one system (Southern Implants) and the remaining twenty-one IACs were made up of seven internal IAC types from four different implant companies (Straumann, Ankylos, and Neodent, Southern Implants). Results. Of the 27 IACs tested, all 6 external IACs leaked measurable amounts of endotoxin. Of the remaining 21 internal IACs, 9 IACs did not show measurable leakage whilst the remaining 12 IACs leaked varying amounts. The mean log endotoxin level was significantly higher for the external compared to internal types (p = 0.015). Conclusion. Within the parameters of this study, we can conclude that endotoxin leakage is dependent on the design of the IAC. Straumann Synocta, Straumann Cross-fit, and Ankylos displayed the best performances of all IACs tested with undetectable leakage after 7 days. Each of these IACs incorporated a morse-like component in their design. Speculation still exists over the impact of IAC endotoxin leakage on peri-implant tissues in vivo; hence, further investigations are required to further explore this.

  13. Leakage of Microbial Endotoxin through the Implant-Abutment Interface in Oral Implants: An In Vitro Study

    PubMed Central

    Mohangi, Govindrau; Malo, Paulo; Nobre, Miguel

    2016-01-01

    Background. Endotoxin initiates osteoclastic activity resulting in bone loss. Endotoxin leakage through implant abutment connections negatively influences peri-implant bone levels. Objectives. (i) To determine if endotoxin can traverse different implant-abutment connection (IAC) designs; (ii) to quantify the amount of endotoxins traversing the IAC; (iii) to compare the in vitro comportments of different IACs. Materials and Methods. Twenty-seven IACs were inoculated with E. coli endotoxin. Six of the twenty-seven IACs were external connections from one system (Southern Implants) and the remaining twenty-one IACs were made up of seven internal IAC types from four different implant companies (Straumann, Ankylos, and Neodent, Southern Implants). Results. Of the 27 IACs tested, all 6 external IACs leaked measurable amounts of endotoxin. Of the remaining 21 internal IACs, 9 IACs did not show measurable leakage whilst the remaining 12 IACs leaked varying amounts. The mean log endotoxin level was significantly higher for the external compared to internal types (p = 0.015). Conclusion. Within the parameters of this study, we can conclude that endotoxin leakage is dependent on the design of the IAC. Straumann Synocta, Straumann Cross-fit, and Ankylos displayed the best performances of all IACs tested with undetectable leakage after 7 days. Each of these IACs incorporated a morse-like component in their design. Speculation still exists over the impact of IAC endotoxin leakage on peri-implant tissues in vivo; hence, further investigations are required to further explore this. PMID:28127552

  14. Bilateral cochlear implantation: current concepts.

    PubMed

    Eapen, Rose J; Buchman, Craig A

    2009-10-01

    The goal of this review is to examine the most recent literature exploring the indications, outcomes, and long-term benefit of bilateral cochlear implantation in children and adults. The indications for cochlear implantation have expanded, as many unilaterally implanted individuals are able to achieve open-set word recognition. Despite the benefits seen in unilateral implantation, many individuals have difficulty perceiving speech in noisy environments. Bilateral cochlear implantation has made great strides in providing individuals access to sound information from both ears, allowing improved speech perception in quiet and in noise, as well as sound localization. Recently, the House Cochlear Implant study group released a position statement in which the group strongly endorsed bilateral cochlear implantation. Improved speech perception in quiet has also been demonstrated by many groups with bilateral implantation. Improved sound localization abilities have been shown to be dependent on interaural level differences. The binaural benefits of head shadow and summation have been long shown in bilaterally implanted individuals. Recently, a growth in squelch has been seen in these individuals likely as a result of increased experience with both implants. This may indicate neural integration of the inputs over time. The literature supports the binaural benefit of bilateral cochlear implantation with demonstrated improved speech perception outcomes in quiet and in noise, sound localization data, and subjective benefits.

  15. Standardized Loads Acting in Knee Implants

    PubMed Central

    Bergmann, Georg; Bender, Alwina; Graichen, Friedmar; Dymke, Jörn; Rohlmann, Antonius; Trepczynski, Adam; Heller, Markus O.; Kutzner, Ines

    2014-01-01

    The loads acting in knee joints must be known for improving joint replacement, surgical procedures, physiotherapy, biomechanical computer simulations, and to advise patients with osteoarthritis or fractures about what activities to avoid. Such data would also allow verification of test standards for knee implants. This work analyzes data from 8 subjects with instrumented knee implants, which allowed measuring the contact forces and moments acting in the joint. The implants were powered inductively and the loads transmitted at radio frequency. The time courses of forces and moments during walking, stair climbing, and 6 more activities were averaged for subjects with I) average body weight and average load levels and II) high body weight and high load levels. During all investigated activities except jogging, the high force levels reached 3,372–4,218N. During slow jogging, they were up to 5,165N. The peak torque around the implant stem during walking was 10.5 Nm, which was higher than during all other activities including jogging. The transverse forces and the moments varied greatly between the subjects, especially during non-cyclic activities. The high load levels measured were mostly above those defined in the wear test ISO 14243. The loads defined in the ISO test standard should be adapted to the levels reported here. The new data will allow realistic investigations and improvements of joint replacement, surgical procedures for tendon repair, treatment of fractures, and others. Computer models of the load conditions in the lower extremities will become more realistic if the new data is used as a gold standard. However, due to the extreme individual variations of some load components, even the reported average load profiles can most likely not explain every failure of an implant or a surgical procedure. PMID:24465856

  16. Engineered porous metals for implants

    NASA Astrophysics Data System (ADS)

    Vamsi Krishna, B.; Xue, Weichang; Bose, Susmita; Bandyopadhyay, Amit

    2008-05-01

    Interest is significant in patient-specific implants with the possibility of guided tissue regeneration, particularly for load-bearing implants. For such implants to succeed, novel design approaches and fabrication technologies that can achieve balanced mechanical and functional performance in the implants are necessary. This article is focused on porous load-bearing implants with tailored micro-as well as macrostructures using laser-engineered net shaping (LENS™), a solid freeform fabrication or rapid prototyping technique that can be used to manufacture patient-specific implants. This review provides an insight into LENS, some properties of porous metals, and the potential applications of this process to fabricate unitized structures which can eliminate longstanding challenges in load-bearing implants to increase their in-vivo lifetime, such as in a total hip prosthesis.

  17. Impression techniques for implant dentistry.

    PubMed

    Chee, W; Jivraj, S

    2006-10-07

    The object of making an impression in implant dentistry is to accurately relate an analogue of the implant or implant abutment to the other structures in the dental arch. This is affected by use of an impression coping which is attached to the implant or implant abutment. This impression coping is incorporated in an impression - much as a metal framework is 'picked up' in a remount impression for fixed prosthodontics. With implant copings the coping is usually attached to the implant or abutment with screws. The impression material used is usually an elastomeric impression material; the two types most widely used and shown to be the most appropriate are polyether and polyvinyl siloxane impression materials.

  18. Clinical management and microscopic characterisation of fatique-induced failure of a dental implant. Case report

    PubMed Central

    Capodiferro, S; Favia, G; Scivetti, M; De Frenza, G; Grassi, R

    2006-01-01

    Background Osseointegrated endosseous implants are widely used for the rehabilitation of completely and partially edentulous patients, being the final prosthodontic treatment more predictable and the failures extremely infrequent. A case of fracture of an endosseous dental implant, replacing the maxillary first molar, occurring in a middle-age woman, 5 years after placement is reported. Materials and methods The difficult management of this rare complication of implant dentistry together with the following rehabilitation is described. Additionally, the authors performed an accurate analysis of the removed fractured implant both by the stereomicroscope and by the confocal laser scanning microscope. Results and discussion The fractured impant showed the typical signs of a fatigue-induced fracture in the coronal portion of the implant together with numerous micro-fractures in the apical one. Three dimensional imaging performed by confocal laser scanning microscope led easily to a diagnosis of "fatigue fracture" of the implant. The biomechanical mechanism of implant fractures when overstress of the implant components due to bending overload is discussed. Conclusion When a fatigue-induced fracture of an dental implant occurs in presence of bending overload, the whole implant suffers a deformation that is confirmed by the alterations (micro-fractures) of the implant observable also in the osseointegrated portion that is easily appraisable by the use of stereomicroscope and confocal laser scanning microscope without preparation of the sample. PMID:16792797

  19. Effect of trehalose coating on basic fibroblast growth factor release from tailor-made bone implants.

    PubMed

    Choi, Sungjin; Lee, Jongil; Igawa, Kazuyo; Suzuki, Shigeki; Mochizuki, Manabu; Nishimura, Ryohei; Chung, Ung-il; Sasaki, Nobuo

    2011-12-01

    Artificial bone implants are often incorporated with osteoinductive factors to facilitate early bone regeneration. Calcium phosphate, the main component in artificial bone implants, strongly binds these factors, and in a few cases, the incorporated proteins are not released from the implant under conditions of physiological pH, thereby leading to reduction in their osteoinductivity. In this study, we coated tailor-made bone implants with trehalose to facilitate the release of basic fibroblast growth factor (bFGF). In an in vitro study, mouse osteoblastic cells were separately cultured for 48 hr in a medium with a untreated implant (T-), trehalose-coated implant (T+), bFGF-incorporated implant (FT-), and bFGF-incorporated implant with trehalose coating (FT+). In the FT+ group, cell viability was significantly higher than that in the other groups (P<0.05). Scanning electron microscopy (SEM) and X-ray diffraction (XRD) revealed that trehalose effectively covered the surface of the artificial bone implant without affecting the crystallinity or the mechanical strength of the artificial bone implant. These results suggest that coating artificial bone implants with trehalose could limit the binding of bFGF to calcium phosphate.

  20. Implantable optoelectronic probes for in vivo optogenetics

    NASA Astrophysics Data System (ADS)

    Iseri, Ege; Kuzum, Duygu

    2017-06-01

    More than a decade has passed since optics and genetics came together and lead to the emerging technologies of optogenetics. The advent of light-sensitive opsins made it possible to optically trigger the neurons into activation or inhibition by using visible light. The importance of spatiotemporally isolating a segment of a neural network and controlling nervous signaling in a precise manner has driven neuroscience researchers and engineers to invest great efforts in designing high precision in vivo implantable devices. These efforts have focused on delivery of sufficient power to deep brain regions, while monitoring neural activity with high resolution and fidelity. In this review, we report the progress made in the field of hybrid optoelectronic neural interfaces that combine optical stimulation with electrophysiological recordings. Different approaches that incorporate optical or electrical components on implantable devices are discussed in detail. Advantages of various different designs as well as practical and fundamental limitations are summarized to illuminate the future of neurotechnology development.

  1. Implantable optoelectronic probes for in vivo optogenetics.

    PubMed

    Iseri, Ege; Kuzum, Duygu

    2017-02-15

    More than a decade has passed since optics and genetics came together and lead to the emerging technologies of optogenetics. The advent of light-sensitive opsins made it possible to optically trigger the neurons into activation or inhibition by using visible light. The importance of spatiotemporally isolating a segment of a neural network and controlling nervous signaling in a precise manner has driven neuroscience researchers and engineers to invest great efforts in designing high precision in vivo implantable devices. These efforts have focused on delivery of sufficient power to deep brain regions, while monitoring neural activity with high resolution and fidelity. In this review, we report the progress made in the field of hybrid optoelectronic neural interfaces that combine optical stimulation with electrophysiological recordings. Different approaches that incorporate optical or electrical components on implantable devices are discussed in detail. Advantages of various different designs as well as practical and fundamental limitations are summarized to illuminate the future of neurotechnology development.

  2. Development of a new, completely implantable intraventricular pressure meter and preliminary report of its clinical experience

    NASA Technical Reports Server (NTRS)

    Osaka, K.; Murata, T.; Okamoto, S.; Ohta, T.; Ozaki, T.; Maeda, T.; Mori, K.; Handa, H.; Matsumoto, S.; Sakaguchi, I.

    1982-01-01

    A completely implantable intracranial pressure sensor designed for long-term measurement of intraventricular pressure in hydrocephalic patients is described. The measurement principal of the device is discussed along with the electronic and component structure and sources of instrument error. Clinical tests of this implanted pressure device involving both humans and animals showed it to be comparable to other methods of intracranial pressure measurement.

  3. Cochlear implants in children implanted in Jordan: A parental overview.

    PubMed

    Alkhamra, Rana A

    2015-07-01

    Exploring the perspective of parents on the cochlear implant process in Jordan. Sixty parents of deaf children were surveyed on the information gathering process prior to cochlear implant surgery, and their implant outcome expectations post-surgery. Whether child or parent characteristics may impact parents' post-surgical expectations was explored. Although parents used a variety of information sources when considering a cochlear implant, the ear, nose and throat doctor comprised their major source of information (60%). Parents received a range of information prior to cochlear implant but agreed (93.3%) on the need for a multidisciplinary team approach. Post-surgically, parents' expected major developments in the areas of spoken language (97%), and auditory skills (100%). Receiving education in mainstream schools (92%) was expected too. Parents perceived the cochlear implant decision as the best decision they can make for their child (98.3%). A significant correlation was found between parents contentment with the cochlear implant decision and expecting developments in the area of reading and writing (r=0.7). Child's age at implantation and age at hearing loss diagnosis significantly affected parents' post-implant outcome expectations (p<0.05). Despite the general satisfaction from the information quantity and quality prior to cochlear implant, parents agree on the need for a comprehensive multidisciplinary team approach during the different stages of the cochlear implant process. Parents' education about cochlear implants prior to the surgery can affect their post-surgical outcome expectations. The parental perspective presented in this study can help professionals develop better understanding of parents' needs and expectations and henceforth improve their services and support during the different stages of the cochlear implant process. Copyright © 2015. Published by Elsevier Ireland Ltd.

  4. Foreign Body Response to Subcutaneous Implants in Diabetic Rats

    PubMed Central

    Socarrás, Teresa Oviedo; Vasconcelos, Anilton C.; Campos, Paula P.; Pereira, Nubia B.; Souza, Jessica P. C.; Andrade, Silvia P.

    2014-01-01

    Implantation of synthetic matrices and biomedical devices in diabetic individuals has become a common procedure to repair and/or replace biological tissues. However, an adverse foreign body reaction that invariably occurs adjacent to implant devices impairing their function is poorly characterized in the diabetic environment. We investigated the influence of this condition on the abnormal tissue healing response in implants placed subcutaneously in normoglycemic and streptozotocin-induced diabetes in rats. In polyether-polyurethane sponge discs removed 10 days after implantation, the components of the fibrovascular tissue (angiogenesis, inflammation, fibrogenesis, and apoptosis) were assessed. Intra-implant levels of hemoglobin and vascular endothelial growth factor were not different after diabetes when compared with normoglycemic counterparts. However, there were a lower number of vessels in the fibrovascular tissue from diabetic rats when compared with vessel numbers in implants from non-diabetic animals. Overall, the inflammatory parameters (neutrophil accumulation - myeloperoxidase activity, tumor necrosis factor alpha, and monocyte chemotactic protein-1 levels and mast cell counting) increased in subcutaneous implants after diabetes induction. However, macrophage activation (N-acetyl-β-D-glucosaminidase activity) was lower in implants from diabetic rats when compared with those from normoglycemic animals. All fibrogenic markers (transforming growth factor beta 1 levels, collagen deposition, fibrous capsule thickness, and foreign body giant cells) decreased after diabetes, whereas apoptosis (TUNEL) increased. Our results showing that hyperglycemia down regulates the main features of the foreign body reaction induced by subcutaneous implants in rats may be relevant in understanding biomaterial integration and performance in diabetes. PMID:25372281

  5. Dental implants with internal versus external connections: 1-year post-loading results from a pragmatic multicenter randomised controlled trial.

    PubMed

    Esposito, Marco; Maghaireh, Hassan; Pistilli, Roberto; Grusovin, Maria Gabriella; Lee, Sang Taek; Gualini, Federico; Yoo, Jungtaek; Buti, Jacopo

    2015-01-01

    To evaluate advantages and disadvantages of identical implants with internal or external connections. Two hundred patients with any type of edentulism (single tooth, partial and total edentulism) requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type but with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea) at seven centres. Due to slight differences in implant design/components, IC implants were platform switched while EC were not. Patients were followed for 1 year after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference assessed by blinded outcome assessors. One hundred and two patients received 173 EC implants and 98 patients received 154 IC implants. Six patients dropped out with 11 EC implants and 3 patients with four IC implants, but all remaining patients were followed up to 1-year post-loading. Two centres did not provide any periapical radiographs. Two prostheses supported by EC implants and one supported by IC implants failed (P = 1.000, difference = -0.01, 95% CI: -0.05 to 0.04). Three EC implants failed in 3 patients versus two IC implants in 1 patient (P = 0.6227, difference = -0.02, 95% CI: -0.07 to 0.03). EC implants were affected by nine complications in 9 patients versus six complications of IC implants in 6 patients (P = 0.5988, difference = -0.02, 95% CI: -0.10 to 0.06). There were no statistically significant differences for prosthesis/implant failures and complications between the implant systems. One year after loading, there were no statistically significant differences in marginal bone level changes between the two groups (difference = 0.24, 95% CI: -0.01 to 0.50, P = 0.0629) and both groups lost bone from implant placement in a statistically significant manner: 0.98 mm for the EC implants and 0.85 mm for

  6. Rupture of poly implant prothèse silicone breast implants: an implant retrieval study.

    PubMed

    Swarts, Eric; Kop, Alan M; Nilasaroya, Anastasia; Keogh, Catherine V; Cooper, Timothy

    2013-04-01

    Poly Implant Prothèse implants were recalled in Australia in April of 2010 following concerns of higher than expected rupture rates and the use of unauthorized industrial grade silicone as a filler material. Although subsequent investigations found that the gel filler material does not pose a threat to human health, the important question of what caused a relatively modern breast implant to have such a poor outcome compared with contemporary silicone breast implants is yet to be addressed. From a cohort of 27 patients, 19 ruptured Poly Implant Prothèse breast implants were subjected to a range of mechanical tests and microscopic/macroscopic investigations to evaluate possible changes in properties as a result of implantation. New Poly Implant Prothèse implants were used as controls. All samples, explanted and controls, complied with the requirements for shell integrity as specified in the International Organization for Standardization 14607. Compression testing revealed rupture rates similar to those reported in the literature. Shell thickness was highly variable, with most shells having regions below the minimum thickness of 0.57 mm that was specified by the manufacturer. Potential regions of stress concentration were observed on the smooth inner surfaces and outer textured surfaces. The high incidence of Poly Implant Prothèse shell rupture is most likely a result of inadequate quality control, with contributory factors being shell thickness variation and manufacturing defects on both inner and outer surfaces of the shell. No evidence of shell degradation with implantation time was determined.

  7. A Systematic Review and Head-to-Head Meta-Analysis of Outcomes following Direct-to-Implant versus Conventional Two-Stage Implant Reconstruction.

    PubMed

    Basta, Marten N; Gerety, Patrick A; Serletti, Joseph M; Kovach, Stephen J; Fischer, John P

    2015-12-01

    Innovative approaches to reconstruction have ushered in an era of breast reconstruction in which direct-to-implant procedures can provide an immediately reconstructed breast. Balancing the benefits against its technical challenges is vital. The authors evaluated the safety and efficacy of using direct-to-implant versus conventional two-stage reconstruction through a systematic meta-analysis. A literature search identified all articles published after 1999 involving prosthetic-based breast reconstruction as a two-stage tissue expander/implant or direct-to-implant technique. The primary outcomes of interest, including implant loss, capsular contracture, reoperation, and infection, were analyzed by means of head-to-head meta-analysis. Thirteen studies involving 5216 breast reconstructions were included. The average patient age was 47.2 ± 1.0 years, the average body mass index was 24.9 ± 0.8 mg/k2, and the average follow-up was 40.8 months. Wound infection, seroma, and capsular contracture risk were similar between groups. However, direct-to-implant reconstruction was associated with a higher risk for skin flap necrosis (OR, 1.43; p = 0.01; I2 = 51 percent) and reoperation (OR, 1.25; p = 0.04; I2 = 43 percent). Ultimately, the risk for implant loss was nearly two-fold higher with direct-to-implant reconstruction compared with tissue expander/implant reconstruction (OR, 1.87; p = 0.04; I2 = 33 percent). Although direct-to-implant and two-stage tissue expander/implant reconstruction are successful approaches, this meta-analysis demonstrates significantly greater risk of flap necrosis and implant failure with direct-to-implant reconstruction. The authors' findings suggest that the critical component of patient selection is judgment of mastectomy flap tissue quality. These findings can enhance the risk counseling process and highlight the need for additional investigations to optimize outcomes.

  8. Piezosurgery in implant dentistry

    PubMed Central

    Stübinger, Stefan; Stricker, Andres; Berg, Britt-Isabelle

    2015-01-01

    Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. PMID:26635486

  9. [Fully implantable hearing systems].

    PubMed

    Maurer, J

    2009-03-01

    As yet comparatively little experience has been gained with fully implantable hearing systems, as the two systems available at present have only recently received CE permission for Europe and the FDA permissions are still pending in the USA. Additionally the technology is expensive and usually not covered by insurance companies. However, it could be shown that by careful patient selection and very careful surgical techniques, good results can be achieved with this highly sensitive technology, often with better patient satisfaction and hearing quality than with conventional hearing aids. To spread the technology further, the systems must also show reliable results on a broad application. Further surgery to change the batteries should not be necessary more frequently than with cardiac pacemakers. Not all technical problems are finally solved. However, it is to be foreseen that fully implantable hearing systems will be a good long-term alternative to conventional hearing aids for some patients.

  10. Piezosurgery in implant dentistry.

    PubMed

    Stübinger, Stefan; Stricker, Andres; Berg, Britt-Isabelle

    2015-01-01

    Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.

  11. Implantable visual prostheses.

    PubMed

    Thanos, S; Heiduschka, P; Stupp, T

    2007-01-01

    Visual impairment and blindness is primarily caused by optic neuropathies like injuries and glaucomas, as well as retinopathies like agerelated macular degeneration (MD), systemic diseases like diabetes, hypertonia and hereditary retinitis pigmentosa (RP). These pathological conditions may affect retinal photoreceptors, or retinal pigment epithelium, or particular subsets of retinal neurons, and in particular retinal ganglion cells (RGCs). The RGCs which connect the retina with the brain are unique cells with extremely long axons bridging the distance from the retina to visual relays within the thalamus and midbrain, being therefore vulnerable to heterogeneous pathological conditions along this pathway. When becoming mature, RGCs loose the ability to divide and to regenerate their accidentally or experimentally injured axons. Consequently, any loss of RGCs is irreversible and results to loss of visual function. The advent of micro- and nanotechnology, and the construction of artificial implants prompted to create visual prostheses which aimed at compensating for the loss of visual function in particular cases. The purpose of the present contribution is to review the considerable engineering expertise that is essential to fabricate current visual prostheses in connection with their functional features and applicability to the animal and human eye. In this chapter, 1) Retinal and cortical implants are introduced, with particular emphasis given to the requirements they have to fulfil in order to replace very complex functions like vision. 2) Advanced work on material research is presented both from the technological and from the biocompatibility aspect as prerequisites of any perspectives for implantation. 3) Ultimately, experimental studies are presented showing the shaping of implants, the procedures of testing their biocompatibility and essential modifications to improve the interfaces between technical devices and the biological environment. The review ends by

  12. Bone Substitutes for Peri-Implant Defects of Postextraction Implants

    PubMed Central

    Santos, Pâmela Letícia; Gulinelli, Jéssica Lemos; Telles, Cristino da Silva; Betoni Júnior, Walter; Chiacchio Buchignani, Vivian; Queiroz, Thallita Pereira

    2013-01-01

    Placement of implants in fresh sockets is an alternative to try to reduce physiological resorption of alveolar ridge after tooth extraction. This surgery can be used to preserve the bone architecture and also accelerate the restorative procedure. However, the diastasis observed between bone and implant may influence osseointegration. So, autogenous bone graft and/or biomaterials have been used to fill this gap. Considering the importance of bone repair for treatment with implants placed immediately after tooth extraction, this study aimed to present a literature review about biomaterials surrounding immediate dental implants. The search included 56 articles published from 1969 to 2012. The results were based on data analysis and discussion. It was observed that implant fixation immediately after extraction is a reliable alternative to reduce the treatment length of prosthetic restoration. In general, the biomaterial should be used to increase bone/implant contact and enhance osseointegration. PMID:24454377

  13. Zirconia in fixed implant prosthodontics.

    PubMed

    Guess, Petra Christine; Att, Wael; Strub, Joerg Rudolf

    2012-10-01

    CAD/CAM technology in combination with zirconia ceramic has increasingly gained popularity in implant dentistry. This narrative review presents the current knowledge on zirconia utilized as framework material for implant-borne restorations and implant abutments, laboratory tests and developments, clinical performance, and possible future trends for implant dentistry are addressed. A review of available literature from 1990 through 2010 was conducted with search terms zirconia,"implants,"abutment,"crown," and "fixed dental prosthesis" using electronic databases (PubMed) and manual searching. Latest applications of zirconia in implant dentistry include implant abutments, multiple unit and full-arch frameworks as well as custom-made bars to support fixed and removable prostheses. High biocompatibility, low bacterial surface adhesion as well as favorable chemical properties of zirconia ceramics are reported. Zirconia stabilized with yttrium oxide exhibits high flexural strength and fracture toughness due to a transformation toughening mechanism. Preliminary clinical data confirmed the high stability of zirconia for abutments and as a framework material for implant borne crowns and fixed dental prostheses. Zirconia abutment or framework damage has rarely been encountered. However, veneering porcelain fractures are the most common technical complication in implant-supported zirconia restorations. These porcelain veneer failures have led to concerns regarding differences in coefficient of thermal expansions between core and veneering porcelain and their respective processing techniques. As presently evidence of clinical long-term data is missing, caution with regard to especially extensive implant-borne zirconia frameworks is recommended. © 2010 Wiley Periodicals, Inc.

  14. [Implantable middle ear hearing aids].

    PubMed

    à Wengen, D F

    2004-01-01

    Conventional acoustic hearing aids are limited in their performance. Due to physical laws their amplification of sound is limited to within 5 kHz. However, the frequencies between 5 and 10 kHz are essential for understanding consonants. Words can only be understood correctly if their consonants can be understood. Furthermore noise amplification remains a problem with hearing aids. Other problems consist of recurrent infections of the external auditory canal, intolerance for occlusion of the ear canal, feedback noise, and resonances in speech or singing. Implantable middle ear hearing aids like the Soundbridge of Symphonix-Siemens and the MET of Otologics offer improved amplification and a more natural sound. Since the first implantation of a Soundbridge in Switzerland in 1996 almost one thousand patients have been implanted worldwide. The currents systems are semi-implantable. The external audio processor containing the microphone, computer chip, battery and radio system is worn in the hair bearing area behind the ear. Implantation is only considered after unsuccessful fitting of conventional hearing aids. In Switzerland the cost for these implantable hearing aids is covered by social insurances. Initially the cost for an implant is higher than for hearing aids. However, hearing aids need replacement every 5 or 6 years whereas implants will last 20 to 30 years. Due to the superior sound quality and the improved understanding of speech in noise, the number of patients with implantable hearing aids will certainly increase in the next years. Other middle ear implants are in clinical testing.

  15. Electronic retinal implant surgery.

    PubMed

    MacLaren, R E

    2017-02-01

    Blindness due to outer retinal degeneration still remains largely untreatable. Photoreceptor loss removes light sensitivity, but the remaining inner retinal layers, the optic nerve, and indeed the physical structure of the eye itself may be unaffected by the degenerative processes. This provides the opportunity to restore some degree of vision with an electronic device in the subretinal space. In this lecture I will provide an overview of our experiences with the first-generation retinal implant Alpha IMS, developed by Retina Implant AG and based on the technology developed by Eberhart Zrenner as part of a multicentre clinical trial (NCT01024803). We are currently in the process of running a second NIHR-funded clinical trial to assess the next-generation device. The positive results from both studies to date indicate that the retinal implant should be included as a potential treatment for patients who are completely blind from retinitis pigmentosa. Evolution of the technology in future may provide further opportunities for earlier intervention or for other diseases.

  16. [Neurotology and cochlear implants].

    PubMed

    Merchán, Miguel A

    2015-05-01

    In this review we analyse cochlear implantation in terms of the fundamental aspects of the functioning of the auditory system. Concepts concerning neuronal plasticity applied to electrical stimulation in perinatal and adult deep hypoacusis are reviewed, and the latest scientific bases that justify early implantation following screening for congenital deafness are discussed. Finally, this review aims to serve as an example of the importance of fostering the sub-specialty of neurotology in our milieu, with the aim of bridging some of the gaps between specialties and thus improving both the knowledge in the field of research on auditory pathologies and in the screening of patients. The objectives of this review, targeted above all towards specialists in the field of otorhinolaryngology, are to analyse some significant neurological foundations in order to reach a better understanding of the clinical events that condition the indications and the rehabilitation of patients with cochlear implants, as well as to use this means to foster the growth of the sub-specialty of neurotology.

  17. Tubo-uterine implantation.

    PubMed

    Green-armytage, V G

    1957-02-01

    After characterizing 2 types of patients presenting with tubal infertility (1 that is "as a rule overweight (the uterus is fixed (and there is easily palpable tubo-uterine pathology," and 1 that is "slim, young, intelligent and often beautiful", 12 1-sentence suggestions are made to increase the success of tubo-uterine implantations in the second type of presenting patient (because the first group has, in the author's mind, disappointing prognosis). Figures are the bulk of the document, with 3 figures demonstrating the type of operation, 3 showing the scheme of the operation, 1 figure showing a posterior view of the implanted tube in utero with a polyethylene prosthesis in situ down to the cervix, and 1 figure showing the instruments used in the operation. A few points of experience the author shares are: 1) operate immediately after a menstrual period; 2) give antibiotics prophylactically and after the procedure; 3) use a Bonney Myomectomy Clamp to elevate the uterus; 4) never use a knife or bistoury at the cornua; 5) use polyethylene rods, when available; and 6) caesarean section is the indicated delivery route after tubo-uterine implantation. Out of 38 patients with the requisite history and findings who have been operated on by this author, 14 have gone to full-term, i.e., 36.1%; 2 have aborted, giving a pregnancy rate of 42.2%, and there was 1 ectopic pregnancy.

  18. Security assessment of magnesium alloys used as biodegradable implant material.

    PubMed

    Sun, X; Cao, Z Y; Liu, J G; Feng, C

    2015-01-01

    The security risk of magnesium alloys used as biodegradable implant material was evaluated in this study. Dose-response assessment was conducted by using toxicological data from authoritative public health agencies (World Health Organization) and assuming 1~3 years of uniform corrosion. Through modification calculation, the tolerable corrosion rate of biodegradable magnesium alloys in vivo was proposed, which theoretically ensured the bio-safety of the degradation products. The tolerable limits corresponding to various component elements in magnesium alloys were considered separately, although there are deficits in the toxicological data of some component elements. The influence of corrosion on the strength of magnesium alloys was evaluated, which would contribute to the rationally utilization of magnesium alloys as degradable implant materials. This study illustrates that not only toxicological calculations but also mechanical performance should be taken into consideration when developing novel degradable metallic implant.

  19. Perioperative Management of Multiple Noncardiac Implantable Electronic Devices.

    PubMed

    Ramos, Juan A; Brull, Sorin J

    2015-12-01

    The number of patients with noncardiac implantable electronic devices is increasing, and the absence of perioperative management standards, guidelines, practice parameters, or expert consensus statements presents clinical challenges. A 69-year-old woman presented for latissimus dorsi breast reconstruction. The patient had previously undergone implantation of a spinal cord stimulator, a gastric pacemaker, a sacral nerve stimulator, and an intrathecal morphine pump. After consultation with device manufacturers, the devices with patient programmability were switched off. Bipolar cautery was used intraoperatively. Postoperatively, all devices were interrogated to ensure appropriate functioning before home discharge. Perioperative goals include complete preoperative radiologic documentation of device component location, minimizing electromagnetic interference, and avoiding mechanical damage to implanted device components.

  20. Materials design considerations involved in the fabrication of implantable bionics by metallization of ceramic substrates.

    PubMed

    Patel, Sunil; Guenther, Thomas; Dodds, Christopher W D; Kolke, Sergej; Privat, Karen L; Matteucci, Paul B; Suaning, Gregg J

    2013-01-01

    The Pt metallization of co-fired Al2O3/SiO2 substrates containing Pt feedthroughs was shown to be a suitable means to construct implantable bionics. The use of forge welding to join an electrode to such a metallized feedthrough was demonstrated and subsequently evaluated through the use of metallography and electron microscopy. Metallurgical phenomena involved in forge welding relevant to the fabrication of all types of biomedical implants are discussed within this paper. The affect of thermal profiles used in brazing or welding to build implantable devices from metal components is analysed and the case for considered selection of alloys in implant design is put forward.

  1. Adaptation of NASA technology for the optimization of orthopedic knee implants

    NASA Technical Reports Server (NTRS)

    Saravanos, D. A.; Mraz, P. J.; Hopkins, D. A.

    1991-01-01

    The NASA technology originally developed for the optimization of composite structures (engine blades) is adapted and applied to the optimization of orthopedic knee implants. A method is developed enabling the tailoring of the implant for optimal interaction with the environment of the tibia. The shape of the implant components are optimized, such that the stresses in the bone are favorably controlled to minimize bone degradation and prevent failures. A pilot tailoring system is developed and the feasibility of the concept is elevated. The optimization system is expected to provide the means for improving knee prosthesis and individual implant tailoring for each patient.

  2. A model for an integrated predoctoral implant curriculum: implementation and outcomes.

    PubMed

    Jahangiri, Leila; Choi, Mijin

    2008-11-01

    The implementation of an implant dental curriculum in U.S. dental schools has been consistently increasing from 33 percent in 1974 to 97 percent in 2004. Among these, only 51 percent have clinical components implemented. A survey of students conducted in 2004 at New York University College of Dentistry (NYUCD) showed an inadequacy in clinical implant restoration experience by graduation. This prompted the development of an extensive dental implant curriculum at NYUCD to meet the needs of the dental students. This report addresses the challenges in implementing such a curriculum and describes a step-by-step approach to develop a program that encompasses didactic, simulation, and patient care components. In 2005, a fully integrated predoctoral implant curriculum was initiated. In 2008, nearly all of the NYUCD students (91.8 percent) completed implant restorations/prosthesis on patients. An assessment revealed a 30 percent increase in students' positive perceptions of the implant curriculum. Based on our experiences at NYUCD, it is recommended that an implant curriculum become part of the core predoctoral curriculum and be integrated throughout the four years of dental education. This article reports on a model for a pre-doctoral implant curriculum, which includes planning, curriculum implementation, program management, and post-implementation stages. Using this model, dental schools can develop implant education for their students that is adapted to their institutional missions, priorities, and resources.

  3. Implantation of the Subcutaneous Implantable Cardioverter-Defibrillator: An Evaluation of 4 Implantation Techniques.

    PubMed

    Brouwer, Tom F; Miller, Marc A; Quast, Anne-Floor B E; Palaniswamy, Chandrasekar; Dukkipati, Srinivas R; Reddy, Vivek; Wilde, Arthur A; Willner, Jonathan M; Knops, Reinoud E

    2017-01-01

    Alternative techniques to the traditional 3-incision subcutaneous implantation of the subcutaneous implantable cardioverter-defibrillator may offer procedural and cosmetic advantages. We evaluate 4 different implant techniques of the subcutaneous implantable cardioverter-defibrillator. Patients implanted with subcutaneous implantable cardioverter-defibrillators from 2 hospitals between 2009 and 2016 were included. Four implantation techniques were used depending on physician preference and patient characteristics. The 2- and 3-incision techniques both place the pulse generator subcutaneously, but the 2-incision technique omits the superior parasternal incision for lead positioning. Submuscular implantation places the pulse generator underneath the serratus anterior muscle and subfascial implantation underneath the fascial layer on the anterior side of the serratus anterior muscle. Reported outcomes include perioperative parameters, defibrillation testing, and clinical follow-up. A total of 246 patients were included with a median age of 47 years and 37% female. Fifty-four patients were implanted with the 3-incision technique, 118 with the 2-incision technique, 38 with submuscular, and 37 with subfascial. Defibrillation test efficacy and shock lead impedance during testing did not differ among the groups; respectively, P=0.46 and P=0.18. The 2-incision technique resulted in the shortest procedure duration and time-to-hospital discharge compared with the other techniques (P<0.001). A total of 18 complications occurred, but there were no significant differences between the groups (P=0.21). All infections occurred in subcutaneous implants (3-incision, n=3; 2-incision, n=4). In the 2-incision group, there were no lead displacements. The presented implantation techniques are feasible alternatives to the standard 3-incision subcutaneous implantation, and the 2-incision technique resulted in shortest procedure duration. © 2017 American Heart Association, Inc.

  4. Engineered PlyCB as Novel Implant Coating for Osseointegration

    DTIC Science & Technology

    2011-09-01

    for visualization by fluorescent microscopy in later aims. Next, we tested the binding of mutants to hydroxyapatite (HA) under various salt, pH...osteoblast, hydroxyapatite , titanium implant, bioactive coating 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF...or shortened lifespan under physiological loads. Coatings such as hydroxyapatite , the mineral component of bone, are often used to promote

  5. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... components under the skin. (b) Classification. Class I (general controls). When made only of surgical grade...

  6. Long latency auditory evoked potentials in children with cochlear implants: systematic review.

    PubMed

    Silva, Liliane Aparecida Fagundes; Couto, Maria Inês Vieira; Matas, Carla Gentile; Carvalho, Ana Claudia Martinho de

    2013-11-25

    The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.

  7. Rationale for the use of CAD/CAM technology in implant prosthodontics.

    PubMed

    Abduo, Jaafar; Lyons, Karl

    2013-01-01

    Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication.

  8. Rationale for the Use of CAD/CAM Technology in Implant Prosthodontics

    PubMed Central

    Abduo, Jaafar; Lyons, Karl

    2013-01-01

    Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication. PMID:23690778

  9. Optical properties of multicomponent antimony-silver nanoclusters formed in silica by sequential ion implantation

    SciTech Connect

    Zuhr, R.A.; Magruder, R.H. III; Anderson, T.S.

    1995-11-01

    The linear and nonlinear optical properties of nanometer dimension metal colloids embedded in a dielectric depend explicitly on the electronic structure of the metal nanoclusters. The ability to control the electronic structure of the nanoclusters may make it possible to tailor the optical properties for enhanced performance. By sequential implantation of different metal ion species multi-component nanoclusters can be formed with significantly different optical properties than single element metal nanoclusters. The authors report the formation of multi-component Sb/Ag nanoclusters in silica by sequential implantation of Sb and Ag. Samples were implanted with relative ratios of Sb to Ag of 1:1 and 3:1. A second set of samples was made by single element implantations of Ag and Sb at the same energies and doses used to make the sequentially implanted samples. All samples were characterized using RBS and both linear and nonlinear optical measurements. The presence of both ions significantly modifies the optical properties of the composites compared to the single element nanocluster glass composites. In the sequentially implanted samples the optical density is lower, and the strong surface plasmon resonance absorption observed in the Ag implanted samples is not present. At the same time the nonlinear response of the these samples is larger than for the samples implanted with Sb alone, suggesting that the addition of Ag can increase the nonlinear response of the Sb particles formed. The results are consistent with the formation of multi-component Sb/Ag colloids.

  10. Assessment of the effect of two occlusal concepts for implant-supported fixed prostheses by finite element analysis in patients with bruxism.

    PubMed

    Göre, Evrim; Evlioğlu, Gülümser

    2014-02-01

    The aim of this study was to evaluate the effects of bruxing forces on implants configured under 2 different occlusal schemes by dynamic finite element analysis. A main model consisting of a 5-unit fixed partial denture supported by 3 implants was simulated with bone, implants, and superstructures. All calculations were made individually for each component, namely porcelain crowns, abutments, abutment screws, implants, and bone. Maximum stresses were found in the group-function occlusion. Group-function loading may result excess stresses on the components compared with canine-guidance loading. According to the results of this study, use of canine guidance is encouraged in bruxers with implant-supported prostheses.

  11. Peri-implant complications for posterior endosteal implants

    PubMed Central

    Esquivel-Upshaw, Josephine; Mehler, Alex; Clark, Arthur; Neal, Dan; Gonzaga, Luiz; Anusavice, Kenneth

    2014-01-01

    Objectives (1) To assess whether there is evidence of an association between the number of peri-implant tissue complications and patient characteristics such as gender, diabetes status, smoking status, and bite force; (2) To assess whether there is evidence of an association between the number of peri-implant tissue complications and location of the implant, surgical technique used, bone graft status and sinus lift status. Materials and Methods This randomized controlled clinical trial included a total of 176 implants (Osseospeed, Dentsply) in 67 participants with 88 fixed dental prostheses. Information was obtained from health histories, a baseline exam, surgical notes, and postoperative exams. The data were analyzed using Fisher's exact and Mann-Whitney tests, and generalized estimating equations logistic regression with a significance level set at 0.05. Results All 176 implants survived within a recall period of three years but 11 implants demonstrated peri-implant tissue complications. Ten sites showed dehiscence and one case exhibited vertical bone loss. There was a statistically significant association between surgical technique used (1-stage or 2-stage) and the presence of soft tissue complications (p = 0.005), where 2-stage surgery was associated with a higher frequency of peri-implant soft tissue complications. A correlation, although not statistically significant (p=0.077) was noted, between peri-implant tissue complications and bone grafting, suggesting a possible role for this factor as well. Conclusions Participants who did not require any second stage surgery at the implant sites experienced fewer complications. Therefore, additional surgical procedures should be performed judiciously considering their possible effects on peri-implant tissue health. PMID:25263400

  12. Transfer characteristics of subretinal visual implants: corneally recorded implant responses.

    PubMed

    Stingl, K; Bartz-Schmidt, K U; Braun, A; Gekeler, F; Greppmaier, U; Schatz, A; Stett, A; Strasser, T; Kitiratschky, V; Zrenner, E

    2016-10-01

    The subretinal Alpha IMS visual implant is a CE-approved medical device for restoration of visual functions in blind patients with end-stage outer retina degeneration. We present a method to test the function of the implant objectively in vivo using standard electroretinographic equipment and to assess the devices' parameter range for an optimal perception. Subretinal implant Alpha IMS (Retina Implant AG, Reutlingen, Germany) consists of 1500 photodiode-amplifier-electrode units and is implanted surgically into the subretinal space in blind retinitis pigmentosa patients. The voltages that regulate the amplifiers' sensitivity (V gl) and gain (V bias), related to the perception of contrast and brightness, respectively, are adjusted manually on a handheld power supply device. Corneally recorded implant responses (CRIR) to full-field illumination with long duration flashes in various implant settings for brightness gain (V bias) and amplifiers' sensitivity (V gl) are measured using electroretinographic setup with a Ganzfeld bowl in a protocol of increasing stimulus luminances up to 1000 cd/m(2). CRIRs are a meaningful tool for assessing the transfer characteristic curves of the electronic implant in vivo monitoring the implants' voltage output as a function of log luminance in a sigmoidal shape. Changing the amplifiers' sensitivity (V gl) shifts the curve left or right along the log luminance axis. Adjustment of the gain (V bias) changes the maximal output. Contrast perception is only possible within the luminance range of the increasing slope of the function. The technical function of subretinal visual implants can be measured objectively using a standard electroretinographic setup. CRIRs help the patient to optimise the perception by adjusting the gain and luminance range of the device and are a useful tool for clinicians to objectively assess the function of subretinal visual implants in vivo.

  13. Graphene synthesis by ion implantation

    PubMed Central

    Garaj, Slaven; Hubbard, William; Golovchenko, J. A.

    2010-01-01

    We demonstrate an ion implantation method for large-scale synthesis of high quality graphene films with controllable thickness. Thermally annealing polycrystalline nickel substrates that have been ion implanted with carbon atoms results in the surface growth of graphene films whose average thickness is controlled by implantation dose. The graphene film quality, as probed with Raman and electrical measurements, is comparable to previously reported synthesis methods. The implantation synthesis method can be generalized to a variety of metallic substrates and growth temperatures, since it does not require a decomposition of chemical precursors or a solvation of carbon into the substrate. PMID:21124725

  14. Short implants: A systematic review

    PubMed Central

    Karthikeyan, I.; Desai, Shrikar R.; Singh, Rika

    2012-01-01

    Background: Short implants are manufactured for use in atrophic regions of the jaws. Although many studies report on short implants as ≤10 mm length with considerable success, the literature regarding survival rate of ≤7 mm is sparse. Purpose: The purpose of this study was to systematically evaluate the publications concerning short dental implants defined as an implant with a length of ≤7 mm placed in the maxilla or in the mandible. Materials and Methods: A Medline and manual search was conducted to identify studies concerning short dental implants of length ≤7 mm published between 1991 and 2011. The articles included in this study report data on implant length ≤7 mm, such as demographic variables, implant type, location in jaws, observation time, prostheses and complications. Results: The 28 included studies represent one randomized controlled trial, 12 prospective studies and 10 retrospective studies. The survival rate of short implant was found to be increased from 80% to 90% gradually, with recent articles showing 100%. Conclusion: When severe atrophy of jaws was encountered, short and wide implants can be placed successfully. PMID:23162320

  15. Implant biomaterials: A comprehensive review

    PubMed Central

    Saini, Monika; Singh, Yashpal; Arora, Pooja; Arora, Vipin; Jain, Krati

    2015-01-01

    Appropriate selection of the implant biomaterial is a key factor for long term success of implants. The biologic environment does not accept completely any material so to optimize biologic performance, implants should be selected to reduce the negative biologic response while maintaining adequate function. Every clinician should always gain a thorough knowledge about the different biomaterials used for the dental implants. This article makes an effort to summarize various dental bio-materials which were used in the past and as well as the latest material used now. PMID:25610850

  16. Surgical Templates for Dental Implant Positioning; Current Knowledge and Clinical Perspectives

    PubMed Central

    Kola, Mohammed Zaheer; Shah, Altaf H; Khalil, Hesham S; Rabah, Ahmed Mahmoud; Harby, Nehad Mohammed H; Sabra, Seham Ali; Raghav, Deepti

    2015-01-01

    Dental implants have been used in a variety of different forms for many years. Since the mid-20th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants. PMID:25838757

  17. Surgical templates for dental implant positioning; current knowledge and clinical perspectives.

    PubMed

    Kola, Mohammed Zaheer; Shah, Altaf H; Khalil, Hesham S; Rabah, Ahmed Mahmoud; Harby, Nehad Mohammed H; Sabra, Seham Ali; Raghav, Deepti

    2015-01-01

    Dental implants have been used in a variety of different forms for many years. Since the mid-20(th) century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

  18. Hollow fiber: a biophotonic implant for live cells

    NASA Astrophysics Data System (ADS)

    Silvestre, Oscar F.; Holton, Mark D.; Summers, Huw D.; Smith, Paul J.; Errington, Rachel J.

    2009-02-01

    The technical objective of this study has been to design, build and validate biocompatible hollow fiber implants based on fluorescence with integrated biophotonics components to enable in fiber kinetic cell based assays. A human osteosarcoma in vitro cell model fiber system has been established with validation studies to determine in fiber cell growth, cell cycle analysis and organization in normal and drug treated conditions. The rationale for implant development have focused on developing benchmark concepts in standard monolayer tissue culture followed by the development of in vitro hollow fiber designs; encompassing imaging with and without integrated biophotonics. Furthermore the effect of introducing targetable biosensors into the encapsulated tumor implant such as quantum dots for informing new detection readouts and possible implant designs have been evaluated. A preliminary micro/macro imaging approach has been undertaken, that could provide a mean to track distinct morphological changes in cells growing in a 3D matrix within the fiber which affect the light scattering properties of the implant. Parallel engineering studies have showed the influence of the optical properties of the fiber polymer wall in all imaging modes. Taken all together, we show the basic foundation and the opportunities for multi-modal imaging within an in vitro implant format.

  19. Bite force and dental implant treatment: a short review.

    PubMed

    Flanagan, Dennis

    2017-01-01

    Dental implants are placed endosseously, and the bone is the ultimate bearer of the occlusal load. Patients are not uniform in the maximum bite force they can generate. The occlusal biting load in the posterior jaw is usually about three times of that found in the anterior. It is possible for supporting implants to be overloaded by the patients' biting force, resulting in bone loss and failure of the fixture. Bite force measurement may be an important parameter when planning dental implant treatment. Some patients can generate extreme biting loads that may cause a luxation of the fixture and subsequent loss of osseointegration. A patient with low biting force may be able to have a successful long-term outcome even with poor anatomical bone qualities. Patients with a high bite force capability may have an increased risk for late component fracture or implant failure. There is no correlation of any bite force value that would indicate any overload of a given implant in a given osseous site. Nonetheless, after bite force measurement, a qualitative judgement may be made by the clinician for the selection of an implant diameter and length and prosthetic design.

  20. [Preoperative and surgical protocols for better implant integration].

    PubMed

    Takács, G

    1994-01-01

    In implant placement, different bone densities require different implant types in order to achieve maximum stability. Therefore, careful preoperative planning is essential to diagnose and/or augment the bone, to select the correct size and type of implant for each individual case, and to establish the appropriate surgical protocol. This paper and presentation discuss the essentials for establishing such protocol, ie, the quality and quantity of bone, type and size of implants, surgery, progressive loading, and shifting of the mastication forces. Serious errors in planning first appear as short-term failures, and they indicate inadequacy in osseointegration in the healing phase or overloading caused by the superstructure. Less grave errors occur later as long-term failures, due to the width, depth, and density of the bone and the angulation of the implant. Appropriate components have to be used for different types of bone: Uncoated screws are the best solution for D1 and D2 types of bone; coated screws should be used in the presinus area and after nerve transpositioning. Cylindrical implants are best suited for subantral augmentation, using a narrow drill; the bone bed is progressively widened by a conic osteotome, and the technique provides a good stability. Free gingival transplant is indicated in cases with insufficient keratinized gingiva. Masticatory overloading can be avoided by reducing the occlusal table, decreasing cusp inclination, and anteriorizing the upper mastication areas.

  1. Carag Bioresorbable Septal Occluder (CBSO) - histopathology of experimental implants.

    PubMed

    Sigler, Matthias; Söderberg, Björn; Schmitt, Boris; Mellmann, Andreas; Bernhard, Jérôme

    2017-05-30

    The aim of the study was to evaluate local biological responses of the partially bioresorbable nonmetal frame Carag Bioresorbable Septal Occluder system in an experimental setting. A Good Laboratory Practices (GLP) study was performed with implantation of the device into the interatrial septum of 24 German landrace pigs with follow- up periods of 3, 5, 8 and 15 months (6 animals in each group). One non-implant related death occurred 1 month after implantation. Histology was obtained by sawing and grinding of the hard-resin embedded specimen after formalin fixation. All occlusion devices were found correctly positioned without any residual shunt at the end of the experiments. Complete endothelialisation could be confirmed histologically in all specimen independent of implantation period. There were only few lymphocytic infiltrations locally related to the implant materials. Sporadic macrophages and foreign body giant cells were found adjacent to the textile fabric. Resorption of the biodegradable frame material was seen to proceed with implantation time. This is the first report on histopathology of a septal defect occluder with bioresorbable filament structure in vivo which already is in clinical use. Good biocompatibility was demonstrated with documentation of timely degradation and substitution of the polymer material by fibromuscular cells and extracellular matrix components.

  2. The design and production of Ti-6Al-4V ELI customized dental implants

    NASA Astrophysics Data System (ADS)

    Chahine, Gilbert; Koike, Mari; Okabe, Toru; Smith, Pauline; Kovacevic, Radovan

    2008-11-01

    This paper addresses the production of customized Ti-6Al-4V ELI dental implants via electron beam melting (EBM). The melting of Ti-6Al-4V ELI powder produces implants with great biocompatibility, fi ne mechanical performance, and a high bone ingrowth potential. The EBM technology is used to produce one-component dental implants that mimic the exact shape of the patient’s tooth, replacing the traditional, three-component, “screw-like” standardized dental implants currently used. The new generation of implants provides the possibility of simplifying pre-insertion procedures leading to faster healing time, and the potential of better and stronger osseointegration, specifi cally through incorporating lattice structure design.

  3. Improvement of rolling contact fatigue life of ion implanted M50 steel

    NASA Astrophysics Data System (ADS)

    Torp, B.; Nielsen, B. R.; Dodd, A.; Kinder, J.; Rangel, C. M.; DaSilva, M. F.; Courage, B.

    1993-06-01

    With the overall objective to improve the service life and reliability of gas turbine engine bearings by increasing their corrosion resistance and rolling contact fatigue life a collaborative project under the EEC BRITE/EURAM program has been initiated and is now in its third year. The aim of the project is to develop an ion implantation technique to implant bearing components with metallic species and to optimise the process, particularly for applications where salt water contamination of the lubricant may occur. As part of the programme leading up to implantation of bearing components, test specimens of M50 bearing steel implanted with Cr + and Ta + at several doses have been characterised by various techniques. This article reports on the implantation work and the rolling contact fatigue measurements which have been performed in order to determine the optimum treatment.

  4. Improvement of corrosion resistance of M50 bearing steel by implantation with metal ions

    NASA Astrophysics Data System (ADS)

    Nielsen, B. R.; Torp, B.; Rangel, C. M.; Simplicio, M. H.; Consiglieri, A. C.; DaSilva, M. F.; Paszti, F.; Soares, J. C.; Dodd, A.; Kinder, J.; Pitaval, M.; Thevenard, P.; Wing, R. G.

    1991-07-01

    With the overall objective to improve the service life and reliability of gas turbine engine bearings by increasing their corrosion resistance and rolling contact fatigue life a collaborative project under the EEC BRITE/EURAM programme has been initiated. The project is aimed at developing an ion implantation technique to implant bearing components with metallic species and to optimise the process particularly for applications where salt-water contamination of the lubricating oil might occur. Prior to implanting into bearing components, test specimens of M50 bearing steel implanted with Cr + and Ta + at several doses have been characterised by various techniques. This article reports on the implantation work, the RBS and NRA analysis for depth profiling and independent dose measurement, and the corrosion resistance measurements which have been performed in order to determine the optimum treatment.

  5. Constrained Implants in Total Knee Replacement.

    PubMed

    Touzopoulos, Panagiotis; Drosos, Georgios I; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-05-01

    Total knee replacement (TKR) is a successful procedure for pain relief and functional restoration in patients with advanced osteoarthritis. The number of TKRs is increasing, and this has led to an increase in revision surgeries. The key to long-term success in both primary and revision TKR is stability, as well as adequate and stable fixation between components and underlying bone. In the vast majority of primary TKRs and in some revision cases, a posterior cruciate retaining or a posterior cruciate substituting device can be used. In some primary cases with severe deformity or ligamentous instability and in most of the revision cases, a more constrained implant is required. The purpose of this paper is to review the literature concerning the use of condylar constrained knee (CCK) and rotating hinge (RH) implants in primary and revision cases focusing on the indications and results. According to this review, although excellent and very good results have been reported, there are limitations of the existing literature concerning the indications for the use of constrained implants, the absence of long-term results, and the limited comparative studies.

  6. Subdermal progestin implant contraception.

    PubMed

    Darney, P D

    1991-08-01

    Sustained-release progestin contraceptives are a new approach to meeting a worldwide need for more effective and acceptable birth control. These contraceptive systems provide low, stable levels of synthetic progestins for periods of months to several years. Unlike earlier injectable and oral contraceptives, they do not cause peaks in progestin levels beyond those required for effective contraception, nor do they employ estrogens. For these reasons, sustained-release progestin systems are without some of the health risks attributed to birth control pills, and they are more effective, as well as easy to use, and completely reversible. They share common side effects, the most frequent of which is irregular menstrual bleeding caused by the erratic shedding of hypotrophic endometrium. Despite this and other minor side effects, most users find the sustained-release systems acceptable alternatives to other methods of contraception. Permanent or biodegradable subdermal implants, injections, intrauterine and intracervical devices, and vaginal rings are all employed as delivery systems for contraceptive progestins. The Norplant (Wyeth Ayerst, Radnor, PA) system, consisting of six silastic tubes filled with levonorgestrel and implanted under the skin, was recently approved by the US Food and Drug Administration and is already used by more than a half million women worldwide. The other sustained-release systems are in various stages of development, at least several years away from general use. When these new methods complete clinical trials, women will be able to choose from among implants, injections, or pellets with various durations of action, all providing convenient, highly effective contraception with low risk to health.

  7. Age at implantation and auditory memory in cochlear implanted children.

    PubMed

    Mikic, B; Miric, D; Nikolic-Mikic, M; Ostojic, S; Asanovic, M

    2014-05-01

    Early cochlear implantation, before the age of 3 years, provides the best outcome regarding listening, speech, cognition an memory due to maximal central nervous system plasticity. Intensive postoperative training improves not only auditory performance and language, but affects auditory memory as well. The aim of this study was to discover if the age at implantation affects auditory memory function in cochlear implanted children. A total of 50 cochlear implanted children aged 4 to 8 years were enrolled in this study: early implanted (1-3y) n = 27 and late implanted (4-6y) n = 23. Two types of memory tests were used: Immediate Verbal Memory Test and Forward and Backward Digit Span Test. Early implanted children performed better on both verbal and numeric tasks of auditory memory. The difference was statistically significant, especially on the complex tasks. Early cochlear implantation, before the age of 3 years, significantly improve auditory memory and contribute to better cognitive and education outcomes.

  8. Heparan Sulfate Proteoglycans and Their Binding Proteins in Embryo Implantation and Placentation

    PubMed Central

    Kirn-Safran, Catherine; D’Souza, Sonia S.; Carson, Daniel D.

    2008-01-01

    Complex interactions occur among embryonic, placental and maternal tissues during embryo implantation. Many of these interactions are controlled by growth factors, extracellular matrix and cell surface components that share the ability to bind heparan sulfate (HS) polysaccharides. HS is carried by several classes of cell surface and secreted proteins called HS proteoglycan that are expressed in restricted patterns during implantation and placentation. This review will discuss the expression of HS proteoglycans and various HS binding growth factors as well as extracellular matrix components and HS-modifying enzymes that can release HS-bound proteins in the context of implantation and placentation. PMID:17766150

  9. Foreign body giant cells selectively covering haptics of intraocular lens implants: indicators of poor toleration?

    PubMed

    Wolter, J R

    1983-10-01

    A Sputnik lens implant removed after five years because of bullous keratopathy exhibits a dense covering of its Supramid anterior staves with large foreign body giant cells, while its Prolene loops and Polymethylmethacrylate optics have attracted only few of these cell units. The glass-membrane-like component of the reactive membrane also shows significant differences on the different parts of this implant. The use of observation of the components of reactive membranes on lens implants as indicators of toleration in the eye is suggested.

  10. Fabrication of a maxillary implant-supported overdenture retained by two cemented bars: a clinical report.

    PubMed

    Uludag, Bulent; Sahin, Volkan; Celik, Gozde

    2007-05-01

    Parallel placement of 2 separate bars may be indicated in patients where bone is available in the posterior part of the maxilla. Bars and stud attachments are the primary attachment systems compatible with the majority of the implant systems currently available; however, treatment planning in certain situations may be challenging due to the component available with the implant system used. This report describes the fabrication of a cemented bar design for use in situations when the components of the implant system are inadequate for fabrication of a screw-retained bar.

  11. Broad beam ion implanter

    DOEpatents

    Leung, K.N.

    1996-10-08

    An ion implantation device for creating a large diameter, homogeneous, ion beam is described, as well as a method for creating same, wherein the device is characterized by extraction of a diverging ion beam and its conversion by ion beam optics to an essentially parallel ion beam. The device comprises a plasma or ion source, an anode and exit aperture, an extraction electrode, a divergence-limiting electrode and an acceleration electrode, as well as the means for connecting a voltage supply to the electrodes. 6 figs.

  12. Broad beam ion implanter

    DOEpatents

    Leung, Ka-Ngo

    1996-01-01

    An ion implantation device for creating a large diameter, homogeneous, ion beam is described, as well as a method for creating same, wherein the device is characterized by extraction of a diverging ion beam and its conversion by ion beam optics to an essentially parallel ion beam. The device comprises a plasma or ion source, an anode and exit aperture, an extraction electrode, a divergence-limiting electrode and an acceleration electrode, as well as the means for connecting a voltage supply to the electrodes.

  13. Gluteal lift with subfascial implants.

    PubMed

    de la Peña-Salcedo, Jose Abel; Soto-Miranda, Miguel Angel; Vaquera-Guevara, Marcelo Osvaldo; Lopez-Salguero, Jose Fernando; Lavareda-Santana, Marco Antonio; Ledezma-Rodriguez, Jocelyn Celeste

    2013-06-01

    Gluteal enhancement surgery includes buttock implants, gluteal flaps, lipografting, and gluteal lifts. However, no information is available on the outcomes achievable using the gluteal lift combined with subfascial gluteal implants. A retrospective study was performed to analyze the outcomes of gluteal lift combined with subfascial gluteal implants performed during a 7-year period by a single surgeon at a single institution. During the study period, 114 patients (228 implants) ages 27-68 years (mean 47 years) were found. The follow-up period was 1-7 years (mean 4.5 years). The findings showed seroma in 11.4 % of the patients, hematoma in 5.26 %, minor wound dehiscence in 19.29 %, major wound dehiscence in 1.75 %, minor infection in 1.75 %, implant exposure in 0 %, capsular contracture Becker 3 and 4 in 3.5 %, implant rupture in 0 %, implant malposition in 5.25 %, long-term numbness of the buttock in 0 %, palpability of the implant in 0 %, implant rippling in 0 %, implant rupture in 0 %, wide scars in 41.2 %, need for secondary surgery in 26.31 %, and dissatisfaction with the final volume in 10.52 %. A patient satisfaction rate of 9.6 in 10 was found. The study showed that the gluteal lift combined with gluteal implants placed in the subfascial pocket provided good long-lasting results with an acceptable rate of complications, very high patient satisfaction, and easily concealed scars. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  14. [Implant rehabilitation of distal mandibular atrophy using a blade implant].

    PubMed

    Veron, C; Chanavaz, M

    1997-11-01

    After a brief revision of the anatomy of the posterior mandible and its natural resorption pattern, the ramus plate-form implant would be the implant of choice for the rehabilitation of this region. This "site specific" implant is inserted on the top of the crest and superficially impacted within the residual alveolar bone at the distal segment of the horizontal branch and guided to climb parallel to the anterior aspect of the ascending ramus. Its form and specific dimensions are perfectly compatible with the frequently limited quantity of available bone above the nerve canal in patients with advanced atrophy of the posterior mandible. It provides a predictable abutment for the implant-supported or dento-implant-supported prostheses of the posterior mandible.

  15. Safety of active implantable devices during MRI examinations: a finite element analysis of an implantable pump.

    PubMed

    Büchler, Philippe; Simon, Anne; Burger, Jürgen; Ginggen, Alec; Crivelli, Rocco; Tardy, Yanik; Luechinger, Roger; Olsen, Sigbjørn

    2007-04-01

    The goal of this study was to propose a general numerical analysis methodology to evaluate the magnetic resonance imaging (MRI)-safety of active implants. Numerical models based on the finite element (FE) technique were used to estimate if the normal operation of an active device was altered during MRI imaging. An active implanted pump was chosen to illustrate the method. A set of controlled experiments were proposed and performed to validate the numerical model. The calculated induced voltages in the important electronic components of the device showed dependence with the MRI field strength. For the MRI radiofrequency fields, significant induced voltages of up to 20 V were calculated for a 0.3T field-strength MRI. For the 1.5 and 3.0OT MRIs, the calculated voltages were insignificant. On the other hand, induced voltages up to 11 V were calculated in the critical electronic components for the 3.0T MRI due to the gradient fields. Values obtained in this work reflect to the worst case situation which is virtually impossible to achieve in normal scanning situations. Since the calculated voltages may be removed by appropriate protection circuits, no critical problems affecting the normal operation of the pump were identified. This study showed that the proposed methodology helps the identification of the possible incompatibilities between active implants and MR imaging, and can be used to aid the design of critical electronic systems to ensure MRI-safety.

  16. An Unusual Bone Loss Around Implants

    PubMed Central

    Rokn, Amir Reza; Sajedinejad, Neda; Yousefyfakhr, Hosnieh; Badri, Samare

    2013-01-01

    Pre-implant disease is an inflammatory process that affects the surrounding tissues of a functional osseointegrated implant. It is usually the result of a disequilibrium between the micro-flora and the defense system. This case reports a 57-year-old man with unusual bone loss around dental implants. This was an unusual case of peri-implantitis that occurred only in the implants on one side of the mouth although they were all unloaded implants. PMID:24396359

  17. A finite element analysis of two different dental implants: stress distribution in the prosthesis, abutment, implant, and supporting bone.

    PubMed

    Quaresma, Sergio E T; Cury, Patricia R; Sendyk, Wilson R; Sendyk, Claudio

    2008-01-01

    This study evaluates the influence of 2 commercially available dental implant systems on stress distribution in the prosthesis, abutment, implant, and supporting alveolar bone under simulated occlusal forces, employing a finite element analysis. The implants and abutments evaluated consisted of a stepped cylinder implant connected to a screw-retained, internal, hexagonal abutment (system 1) and a conical implant connected to a solid, internal, conical abutment (system 2). A porcelain-covered, silver-palladium alloy was used as a crown. In each case, a simulated, 100-N vertical load was applied to the buccal cusp. A finite element model was created based on the physical properties of each component, and the values of the von Mises stresses generated in the prosthesis, abutment, implant, and supporting alveolar bone were calculated. In the prostheses, the maximum von Mises stresses were concentrated at the points of load application in both systems, and they were greater in system 1 (148 N/mm2) than in system 2 (55 N/mm2). Stress was greater on the abutment of system 2 than of system 1 on both the buccal (342 N/mm2 x 294 N/mm2) and lingual (294 N/mm2 x 148 N/ mm2) faces. Stress in the cortical, alveolar bone crest was greater in system 1 than in system 2 (buccal: 99.5 N/mm2 x 55 N/mm2, lingual: 55 N/mm2 x 24.5 N/mm2, respectively). Within the limits of this investigation, the stepped cylinder implant connected to a screw-retained, internal hexagonal abutment produces greater stresses on the alveolar bone and prosthesis and lower stresses on the abutment complex. In contrast, the conical implant connected to a solid, internal, conical abutment furnishes lower stresses on the alveolar bone and prosthesis and greater stresses on the abutment.

  18. Dental implant changes following incineration.

    PubMed

    Berketa, J; James, H; Marino, V

    2011-04-15

    Non-visual identification of victims utilizes DNA, fingerprint and dental comparison as primary scientific identifiers. In incidents where a victim has been incinerated, there may be loss of fingerprint detail and denaturing of DNA. Although extremely durable, tooth loss will also occur with extreme temperatures and the characteristics of recovered dental implants, if any, may be the only physical identifying data available. Currently, there are no experimental investigations to determine what changes occur to dental implants following high temperature exposure. A selection of dental implants was radiographed, utilizing purpose built apparatus to allow standard methodology. They were then heated in an INFI-TROL™ kiln to a maximum temperature of 1125°C and the radiographic procedure repeated. Image subtraction evaluation of the radiographs was recorded using Adobe(®) Photoshop(®). Both commercially pure titanium and titanium alloy dental implants survived the incineration and there was oxidation of the surface leading to minor alteration of the image. There was, however, no detectable sagging of the implants. The results of this research suggest that dental implants are still recognizable following incineration. In scenarios commonly seen by forensic odontologists, heat will destroy both teeth and conventional dental restorative materials. Implants, however, will resist these conditions and will also retain the features necessary to identify the type of implant. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Implant Maintenance: A Clinical Update

    PubMed Central

    Gulati, Minkle; Govila, Vivek; Anand, Vishal; Anand, Bhargavi

    2014-01-01

    Introduction. The differences in the supporting structure of the implant make them more susceptible to inflammation and bone loss when plaque accumulates as compared to the teeth. Therefore, a comprehensive maintenance protocol should be followed to ensure the longevity of the implant. Material and Method. A research to provide scientific evidence supporting the feasibility of various implant care methods was carried out using various online resources to retrieve relevant studies published since 1985. Results. The electronic search yielded 708 titles, out of which a total of 42 articles were considered appropriate and finally included for the preparation of this review article. Discussion. A typical maintenance visit for patients with dental implants should last 1 hour and should be scheduled every 3 months to evaluate any changes in their oral and general history. It is essential to have a proper instrument selection to prevent damage to the implant surface and trauma to the peri-implant tissues. Conclusion. As the number of patients opting for dental implants is increasing, it becomes increasingly essential to know the differences between natural teeth and implant care and accept the challenges of maintaining these restorations. PMID:27437506

  20. 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

  1. Conductive polymer sensor arrays for smart orthopaedic implants

    NASA Astrophysics Data System (ADS)

    Micolini, Carolina; Holness, F. B.; Johnson, James A.; Price, Aaron D.

    2017-04-01

    This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smartpolymer sensor array using conductive polyaniline (PANI) structures embedded in a polymeric substrate. The piezoresistive characteristics of PANI were studied to evaluate the efficacy of the manufacturing of an embedded pressure sensor. PANI's stability throughout loading and unloading cycles together with the response to incremental loading cycles was investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is a good candidate for the manufacture of implant components with smart-polymer sensors embedded for the analysis of joint loads in orthopaedic implants.

  2. Peri-implant complications for posterior endosteal implants.

    PubMed

    Esquivel-Upshaw, Josephine; Mehler, Alex; Clark, Arthur; Neal, Dan; Gonzaga, Luiz; Anusavice, Kenneth

    2015-12-01

    (1) To assess whether there is evidence of an association between the number of peri-implant tissue complications and patient characteristics such as gender, diabetes status, smoking status, and bite force; (2) To assess whether there is evidence of an association between the number of peri-implant tissue complications and location of the implant, surgical technique used, bone graft status and sinus lift status. This randomized, controlled clinical trial included a total of 176 implants (OsseoSpeed, DENTSPLY) in 67 participants with 88 fixed dental prostheses. Information was obtained from health histories, a baseline exam, surgical notes, and post-operative exams. The data were analyzed using Fisher's exact and Mann-Whitney tests and generalized estimating equations using logistic regression with a significance level set at 0.05. All 176 implants survived within a recall period of 3 years, but 11 implants demonstrated peri-implant tissue complications. Ten sites showed dehiscence and one case exhibited vertical bone loss. There was a statistically significant association between surgical technique used (1-stage or 2-stage) and the presence of soft tissue complications (P = 0.005), where 2-stage surgery was associated with a higher frequency of peri-implant soft tissue complications. A correlation, although not statistically significant (P = 0.077), was noted, between peri-implant tissue complications and bone grafting, suggesting a possible role for this factor as well. Participants who did not require any second-stage surgery at the implant sites experienced fewer complications. Therefore, additional surgical procedures should be performed judiciously considering their possible effects on peri-implant tissue health. The clinical implication of this research study is that secondary surgery should be considered with caution during implant placement and it should be performed only when other options have been exhausted, as it has been shown to have a direct

  3. Cochlear implantation following cerebellar surgery.

    PubMed

    Saeed, Shahad; Mawman, Deborah; Green, Kevin

    2011-08-01

    Cochlear implantation in patients with known central nervous system conditions can result in wide-ranging outcomes. The aim of this study is to report two cases of cochlear implantation outcomes in patients with acquired cerebellar ataxia following cerebellar surgery. The first is a female implanted with the Nucleus 24 implant in September 2000 and the second is a male implanted with a MED-EL Sonata Flexsoft electro-acoustic stimulation in July 2009. Programming these patients resulted in significant non-auditory stimulation which resulted in less than optimum map fittings. The patients did not gain any open set speech perception benefit although both of them gained an awareness of sound with the device. However, patient 2 elected to become a non-user because of the limited benefit.

  4. Implant fixation by bone ingrowth.

    PubMed

    Kienapfel, H; Sprey, C; Wilke, A; Griss, P

    1999-04-01

    The term osseointegration referred originally to an intimate contact of bone tissue with the surface of a titanium implant; the term bone ingrowth refers to bone formation within an irregular (beads, wire mesh, casting voids, cut grooves) surface of an implant. The section dealing with the historical background describes the development of macroporous, microporous, and textured surfaces with an emphasis on the evolution of porous and textured metal surfaces. The principal requirements for osseointegration and bone ingrowth are systematically reviewed as follows: i) the physiology of osseointegration and bone ingrowth, including biomaterial biocompatibility with respect to cellular and matrix response at the interface; ii) the implant surface geometry characteristics; iii) implant micromotion and fixation modes; and iv) the implant-bone interface distances. Based on current methods of bone ingrowth assessment, this article comparatively reviews and discusses the results of experimental studies with the objective of determining local and systemic factors that enhance bone ingrowth fixation.

  5. Bimodal fitting or bilateral implantation?

    PubMed

    Ching, Teresa Y C; Massie, Robyn; Van Wanrooy, Emma; Rushbrooke, Emma; Psarros, Colleen

    2009-01-01

    This paper summarises findings from studies that evaluated the benefits of bimodal fitting (combining a hearing aid and a cochlear implant in opposite ears) or bilateral cochlear implantation, relative to unilateral implantation, for children (Ching et al., 2007). On average, the size of binaural speech intelligibility advantages due to redundancy and head shadow was similar for the two bilateral conditions. An added advantage of bimodal fitting was that the low-frequency cues provided by acoustic hearing complemented the high-frequency cues conveyed by electric hearing in perception of voice and music. Some children with bilateral cochlear implants were able to use spatial separation between speech and noise to improve speech perception in noise. This is possibly a combined effect of the directional microphones in their implant systems and their ability to use spatial cues. The evidence to date supports the provision of hearing in two ears as the standard of care.

  6. Progestin implants for female contraception.

    PubMed

    Croxatt, Horacio B

    2002-01-01

    Four different implants, in the form of capsules or covered rods, that release one of the synthetic progestins levonorgestrel, etonogestrel, Nestorone, or Elcometrine and nomegestrol acetate were reviewed. Biocompatible polymers or copolymers of polydimethyl/polymethylvinyl-siloxanes or ethylvinylacetate are used to hold the steroid crystals and to control the rate of release. Once inserted under the skin, these implants release the corresponding steroid continuously over prolonged periods, a process that can be readily interrupted by implant removal. During long-term use of the implant, the released steroid circulates in blood at a fairly stable level. The physical characteristics of the implants, including drug contents and rate of release, serum levels of the progestin during use, and the duration of their effective life are described. Total steroid loads vary in the range of 50 mg to 216 mg; average release rates are in the range of 30-100 ug/day, and effective lives from 6 months to 7 years.

  7. Hydrogen Implants for Layer Exfoliation

    NASA Astrophysics Data System (ADS)

    Cherekdjian, S.; Couillard, J. G.; Wilcox, C.

    2011-01-01

    Researchers at Corning Incorporated have developed a process whereby single crystal silicon thin films are transferred onto a flat panel display glass substrate using hydrogen ion implantation. The energy of the implant controls the effective exfoliation thickness, agreeing well with SRIM calculations, while the hydrogen ion dose controls the size of the platelets formed. The ion dose was found to influence the final void defect count in exfoliated films. Finally, the ion beam and ion implant end-station cooling characteristics were investigated. These parameters control the effective implant heat load generated during ion beam processing. The temperature at which exfoliation occurs during an exfoliation heat cycle was found to be inversely proportional to the hydrogen ion dose when the temperature during ion implantation is <100 °C. The most sensitive exfoliation temperature to ion dose dependence was observed for cooler implants, i.e. <35 °C. Data indicates that at the minimum exfoliation dose the exfoliation temperature is reduced significantly by increasing the implant heat generated during ion beam processing. Higher hydrogen doses than the minimum required for exfoliation exhibit only a small exfoliation temperature variation with ion dose. By optimizing the implant heat load generated during ion beam processing it is observed that the efficiency of the exfoliation process is also enhanced. Implant temperatures of 150 to 160 °C were found to further reduce the minimum implant dose required for exfoliation by an additional 5%, as verified by calorimetric measurements. These results enable us to further conclude that hydrogen out-diffusion is not significant in this process.

  8. Dental implants with internal versus external connections: 5-year post-loading results from a pragmatic multicenter randomised controlled trial.

    PubMed

    Esposito, Marco; Maghaireh, Hassan; Pistilli, Roberto; Grusovin, Maria Gabriella; Lee, Sang Taek; Trullenque-Eriksson, Anna; Gualini, Federico

    To evaluate advantages and disadvantages of identical implants with internal or external connections. One hundred and twenty patients with any type of edentulism (single tooth, partial and total edentulism), requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea), at four centres. Due to slight differences in implant design and components, IC implants were platformswitched while EC were not. Patients were followed for 5 years after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference, assessed by blinded outcome assessors. Sixty patients received 96 EC implants and 60 patients received 107 IC implants. Three patients dropped out with four EC implants and five patients with ten IC implants, but all remaining patients were followed up to 5-year post-loading. One prosthesis supported by EC implants and two by IC implants failed (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). One EC implant failed versus three IC implants in two patients (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). Ten complications occurred in 10 EC patients versus nine complications in 9 IC patients (P = 1.000, difference = 0.01, 95% CI: -0.13 to 0.15). There were no statistically significant differences for prosthesis and implant failures and complications between the different connection types. Five years after loading, there were no statistically significant differences in marginal bone level estimates between the two groups (difference = 0.14 mm, 95% CI: -0.28 to 0.56, P (ancova) = 0.505) and both groups lost bone from implant placement in a statistically significant way: 1.13 mm for the EC implants and 1.21 mm for the IC implants. Two operators had no preference and two preferred IC implants

  9. Effect of surface treatment on stress distribution in immediately loaded dental implants--a 3D finite element analysis.

    PubMed

    Bahrami, Babak; Shahrbaf, Shirin; Mirzakouchaki, Behnam; Ghalichi, Farzan; Ashtiani, Mohammed; Martin, Nicolas

    2014-04-01

    To investigate, by means of FE analysis, the effect of surface roughness treatments on the distribution of stresses at the bone-implant interface in immediately loaded mandibular implants. An accurate, high resolution, digital replica model of bone structure (cortical and trabecular components) supporting an implant was created using CT scan data and image processing software (Mimics 13.1; Materialize, Leuven, Belgium). An anatomically accurate 3D model of a mandibular-implant complex was created using a professional 3D-CAD modeller (SolidWorks, DassaultSystèmes Solid Works Corp; 2011). Finite element models were created with one of the four roughness treatments on the implant fixture surface. Of these, three were surface treated to create a uniform coating determined by the coefficient of friction (μ); these were either (1) plasma sprayed or porous-beaded (μ=1.0), (2) sandblasted (μ=0.68) or (3) polished (μ=0.4). The fourth implant had a novel two-part surface roughness consisting of a coronal polished component (μ=0.4) interfacing with the cortical bone, and a body plasma treated surface component (μ=1) interfacing with the trabecular bone. Finite element stress analysis was carried out under vertical and lateral forces. This investigation showed that the type of surface treatment on the implant fixture affects the stress at the bone-implant interface of an immediately loaded implant complex. Von Mises stress data showed that the two-part surface treatment created the better stress distribution at the implant-bone interface. The results from this FE computational analysis suggest that the proposed two-part surface treatment for IL implants creates lower stresses than single uniform treatments at the bone-implant interface, which might decrease peri-implant bone loss. Future investigations should focus on mechanical and clinical validation of these FE results. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  10. Tribological properties of nitrogen implanted and boron implanted steels

    SciTech Connect

    Kern, K.T.; Walter, K.C.; Griffin, A.J. Jr.; Kung, H.; Lu, Y.; Nastasi, M.; Tesmer, J.R.; Fayeulle, S.

    1996-06-01

    Samples of a steel with high chrome content was implanted separately with 75 keV nitrogen ions and with 75 keV boron ions. Implanted doses of each ion species were 2-, 4-, and 8 {times} 10{sup 17}/cm{sup 2}. Retained doses were measured using resonant non-Rutherford Backscattering Spectrometry. Tribological properties were determined using a pin-on-disk test with a 6-mm diameter ruby pin with a velocity of 0.94 m/min. Testing was done at 10% humidity with a load of 377 g. Wear rate and coefficient of friction were determined from these tests. While reduction in the wear rate for nitrogen implanted materials was observed, greater reduction (more than an order of magnitude) was observed for boron implanted materials. In addition, reduction in the coefficient of friction for high-dose boron implanted materials was observed. Nano-indentation revealed a hardened layer near the surface of the material. Results from grazing incidence x-ray diffraction suggest the formation of Fe{sub 2}N and Fe{sub 3}N in the nitrogen implanted materials and Fe{sub 3}B in the boron implanted materials. Results from transmission electron microscopy will be presented.

  11. Biocompatible gradient ceramic coatings for metal implants

    NASA Astrophysics Data System (ADS)

    Sharkany, Josif P.; Sichka, Mikhail J.; Potapchuk, Anatolij M.; Lemko, Ivan S.; Pintye, Josif L.

    2001-08-01

    For the acceleration of the osteointegration processes of the metals implants we deposit on their surface the biokompotible ceramic coatings on the basis of hydroxyapatite. However such coatings have a certain deficiency connected with the absence of the necessary strength characteristics for a such kind of the implant. That's why it actual to create the coatings having beside biological compatibility the necessary strength and springy- elastic properties. We have developed the method of the receiving of the new biocompatible coatings with gradient structure over width on the titanium substrate. The essence of the developed method is in plasma coatings deposition within beforehand given supply of the powder consisting of two components (oxyde aluminum and hydroxyapatite) in the process of the deposition. It's showed that the received gradient coatings are the mixture of the crystals Al2O3 and HA, the concentrations of which change over the width. The topological investigation of the surface and the coating cross-sections was performed from which the chemical composition distribution over width was studied and found the absense of the chemical interaktion between Al2O3 and HA. By regulation of the distribution of the initial components over the coating widths it is possible to set the phase comsposition and crystal sizes in the biocompatible coatings. In the process of etching in the solutions imitating the physiological ones it is found the formation of the pores having dendritic structure. The performed investigations show the possibility of the usage of the developed coatings in medicine particularly in stomatolgoy.

  12. Nonlinear contact analysis of preload in dental implant screws.

    PubMed

    Sakaguchi, R L; Borgersen, S E

    1995-01-01

    Clinical studies indicate that loosening or fracture of dental implant prostheses occurs in 5% to 45% of cases during the first year. The nature of loosening or displacement of prosthetic components is complex, since it involves cycling fatigue, oral fluids, and varied chewing patterns and loads. A finite element contact analysis method was used to study the load-transfer mechanism between prosthetic components caused by torque application to the threaded fasteners used for assembly. Screw elongation is achieved while allowing for elastic recovery of the screw to produce a clamping force on the fastened elements. Clamping forces were additive along the axis of the prosthetic components. When the gold retaining screw is fastened into the abutment screw, clamping force on the implant is increased at the expense of decreasing the clamping force at the abutment screw-abutment interface by 50%. Maximum tensile stresses in the screws after preload were less than 55% of the yield stress.

  13. Double valve Implantation

    PubMed Central

    Stassano, Paolo; Mannacio, Vito; Musumeci, Antonino; Golino, Alessandro; Maida, Piero; Ferrigno, Vincenzo; Buonocore, Gaetano; Spampinato, Nicola

    1991-01-01

    From January 1976 through December 1987, 194 patients with a mean age of 43.3 ± 13.7 years (range, 11 to 74 years) underwent double (mitral and aortic) replacement of native valves with 8 types of bioprostheses: Carpentier-Edwards, 127 valves; Hancock, 76 valves; Liotta-Bioimplant, 57 valves; Ionescu-Shiley, 53 valves; Vascor, 27 valves; Carpentier-Edwards Pericardial, 22 valves; Angell-Shiley, 20 valves; and Implamedic, 6 valves. Concomitant cardiac procedures were performed in 25 patients (12.8%). There were 18 operative deaths (9.27%). Our retrospective analysis was restricted to 352 bioprostheses implanted in the 176 patients who survived surgery and were considered at risk for valve tissue failure. The overall cumulative duration of follow-up was 1,174.1 patient-years (range, 1 to 13 years). The durations of follow-up for specific valves were: Carpentier-Edwards, 920.2 valve-years; Hancock, 383.8 valve-years; Liotta-Bioimplant, 310.2 valve-years; Ionescu-Shiley, 357.7 valve-years; Vascor, 131.2 valve-years; Carpentier-Edwards Pericardial, 52.0 valve-years; Angell-Shiley, 167.0 valve-years; and Implamedic, 31.0 valve-years. Thirty patients had thromboembolic accidents, for a linearized incidence of 2.5% per patient-year. At 13 years, the actuarial freedom from thromboembolic accidents was 85.8% ± 10.7%. Nine patients had endocarditis, for a linearized incidence of 0.7% per patient-year. At 13 years, the actuarial freedom from endocarditis was 92.0% ± 1.5%. Twenty-four patients had valve tissue failure, for a cumulative linearized incidence of 1.87% per valve-year. The cumulative actuarial probability of freedom from valve tissue failure was 78.6% ± 3.7% at 10 years and 51.2% ± 10.7% at 13 years. The 24 patients with valve tissue failure all underwent reoperation: 20 of these had double valve replacement, 3 had aortic valve replacement alone, and 1 had mitral valve replacement alone. The mean interval between initial valve implantation and reoperation was

  14. Diabetes alters inflammation, angiogenesis, and fibrogenesis in intraperitoneal implants in rats.

    PubMed

    Oviedo-Socarrás, Teresa; Vasconcelos, Anilton C; Barbosa, Irma X; Pereira, Nubia B; Campos, Paula P; Andrade, Silvia P

    2014-05-01

    The increased prevalence of diabetes worldwide is associated with increasing numbers of diabetic individuals receiving synthetic matrices and biomedical implants to repair and/or replace biological tissues. This therapeutic procedure invariably leads to adverse tissue healing (foreign body reaction), thus impairing the biomedical device function of subcutaneous implants. However, the influence of diabetes on abnormal tissue healing in intraperitoneal implants is unclear. We investigated key components of foreign body reactions in diabetic rats. Polyether-polyurethane sponge discs were placed intraperitoneally in rats previously injected with streptozotocin for induction of diabetes and in non-diabetic rats. Implants removed 10 days after implantation were assessed by determining the components of the fibrovascular tissue (angiogenesis, inflammation, and fibrogenesis). In implants from diabetic rats, fibrous capsule thickness and fibrovascular tissue infiltration (hematoxylin & eosin and picrosirius staining) were reduced in comparison with implants from non-diabetic rats. Hemoglobin (Hb) content (vascular index) and VEGF levels (pro-angiogenic cytokine) were increased after diabetes. However, the number of vessels (H&E and CD31-immunostaining) in the fibrovascular tissue from diabetic rats was decreased when compared with vessel numbers in implants from non-diabetic animals. Overall, all inflammatory parameters (macrophage accumulation-NAG activity; TNF-α and MCP-1 levels) increased in intraperitoneal implants after diabetes induction. The pro-fibrogenic cytokine (TGFβ-1) increased after diabetes, but collagen deposition remained unaltered in the implants from diabetic rats. These important diabetes-related changes (increased levels of pro-inflammatory and angiogenic and fibrogenic cytokines) in peritoneal implant healing provide an insight into the mechanisms of the foreign body response in the diabetic environment in rats. Copyright © 2014 Elsevier Inc. All

  15. Management of fluocinolone implant dissociation during implant exchange.

    PubMed

    Yeh, Steven; Cebulla, Colleen M; Witherspoon, S Robert; Emerson, Geoffrey G; Emerson, M Vaughn; Suhler, Eric B; Albini, Thomas A; Flaxel, Christina J

    2009-09-01

    Three patients with chronic, noninfectious uveitis requiring immunosuppressive therapy underwent fluocinolone acetonide (FA) implant exchange complicated by dissociation of the medication reservoir from its anchoring strut. In 2 patients, the medication reservoir descended into the vitreous cavity and required pars plana vitrectomy with intraocular foreign body removal techniques for its retrieval. The use of viscoelastic or perfluorocarbon to elevate the device was helpful in the safe removal of the FA implant device. Surgeons performing FA implant exchange should be aware of this potential complication and anticipate the possible need for vitreoretinal instrumentation and personnel. Patients undergoing FA explantation or exchange should be counseled regarding this potential complication prior to surgery.

  16. An evaluation of torque (moment) on implant/prosthesis with staggered buccal and lingual offset.

    PubMed

    Weinberg, L A; Kruger, B

    1996-06-01

    The supposition that staggered buccal and lingual implant offset is biomechanically advantageous was examined mathematically. The method of evaluation utilized a standard hypothetical geometric configuration from which implants could be staggered buccally and/or lingually in both arches. Torque (moment) values were calculated at the gold screw, abutment screw, and 3.5 mm apical to the head of the implant. Comparisons were made in percentages of change from the hypothetical standard to the buccal and/or lingual implant offset. In the maxillary arch, buccal offset decreased the torque (moment) while lingual offset increased it. If more lingually offset implants were present in the maxillary restoration, the total torque would be greater than if they were all in a straight line. Staggered buccolingual implant alignment often requires abutment reangulation. The resultant line of force produced by occlusal anatomy usually results in buccal inclination in the maxillary arch and lingual inclination in the mandibular arch. As a result, mandibular implant/prostheses are greatly favored over similar maxillary configurations because the mandibular resultant line of force usually passes lingually, closer to the components and supporting bone and considerably less torque is produced. Therefore, the concept of staggered offset for multiple implant-supported prostheses can be utilized on the mandible but is not recommended for the maxilla where maximum uniform buccal implant orientation is advised.

  17. [Implantable artificial heart].

    PubMed

    Nojiri, Chisato

    2005-11-01

    Heart transplants have been decreasing globally due to the lack of available donor hearts. As a result, the increased use of artificial hearts is anticipated as an alternative therapy. Although biocompatibility issues, such as thrombus formation/thromboembolism and infection, are still the main cause of mortality associated with artificial hearts, more than 20 different types are now clinically available after a half-century of development and experimental trials. These devices range from extracorporeal pneumatic to implantable battery-powered artificial hearts. The early development of artificial hearts logically focused on volumetric pump designs incorporating functions similar to the natural heart. Today, development has shifted toward designs that are significantly different from the natural heart. These pumps utilize axial or centrifugal flow allowing for a much simpler design, which is smaller in size and has very few moving parts. With rapid advances in technology, this new generation of artificial heart pumps is beginning to emerge as an alternative to heart transplants.

  18. [2- to 5-year follow-up of cementless implantable knee joint prosthesis of the Miller-Galante type].

    PubMed

    Kienapfel, H; Griss, P; Orth, J; Roloff, K; Malzer, U

    1991-06-01

    Based on a prospective study protocol, the two- to five-year results of the Miller-Galante cementless total knee arthroplasty are presented. Sixty-four implants were placed in 59 patients: 60 implantations were cementless and 4 cemented. Clinically, the scores for pain, range of motion, walking and stair climbing improved significantly. Radiographically, the uncemented components displayed no signs of definite or possible loosening, whereas one of the cemented components was found to be definitely loose. On histological evaluation of the retrieved implants, all components had bone ingrowth.

  19. [Biodeterioration and corrosion of metallic implants and prostheses].

    PubMed

    López, G D

    1993-01-01

    The use of surgical implants and prosthetic devices to replace the original function of different components of the human biological system is a well established tradition in the history of medicine. Currently, one of the most prevalent points of view in dealing with this subject, is that of biocompatibility of materials of construction and methods of fabrication of these devices, in order to avoid negative impacts on the patient due to failure of implants through degradation mechanisms such as corrosion. This article presents a current general review of the relationship between biocompatibility and deterioration of metallic implants and prosthetic devices, emphasizing the specific forms that corrosion adopts in biological media. The historical perspective shows the consolidation of a tendency towards a more systematic study of these phenomena in recent years, as opposed to trial and error practices that used to be common before the third decade of this century. The understanding of interactions between implants and biological tissue, thus led to some of the most promising current techniques, such as the use of powder metallurgy components to optimize skeletal fixation of implants by means of interstitial bone growth into porous metallic surfaces. The review of metals and alloys currently used for the fabrication of implants shows the amplitude of available technological alternatives, as well as the multiple criteria required to make a good selection for each specific case. Applications and pros and cons of stainless steel, Cr, Ni, Co and Ti alloys, and tantalum are briefly discussed. The introduction to basic concepts of corrosion, serves as a basis for the description of the typical forms that these phenomena adopt in biological media, including pitting, crevice corrosion, fatigue-corrosion, stress corrosion, fretting corrosion, galvanic corrosion, and intergranular corrosion. This review shows that the study of interactions between biological media and metallic

  20. Microsystems Technology for Retinal Implants

    NASA Astrophysics Data System (ADS)

    Weiland, James

    2005-03-01

    The retinal prosthesis is targeted to treat age-related macular degeneration, retinitis pigmentosa, and other outer retinal degenerations. Simulations of artificial vision have predicted that 600-1000 individual pixels will be needed if a retinal prosthesis is to restore function such as reading large print and face recognition. An implantable device with this many electrode contacts will require microsystems technology as part of its design. An implantable retinal prosthesis will consist of several subsystems including an electrode array and hermetic packaging. Microsystems and microtechnology approaches are being investigated as possible solutions for these design problems. Flexible polydimethylsiloxane (PDMS) substrate electrode arrays and silicon micromachined electrode arrays are under development. Inactive PDMS electrodes have been implanted in 3 dogs to assess mechanical biocompatibility. 3 dogs were followed for 6 months. The implanted was securely fastened to the retina with a single retinal tack. No post-operative complications were evident. The array remained within 100 microns of the retinal surface. Histological evaluation showed a well preserved retina underneath the electrode array. A silicon device with electrodes suspended on micromachined springs has been implanted in 4 dogs (2 acute implants, 2 chronic implants). The device, though large, could be inserted into the eye and positioned on the retina. Histological analysis of the retina from the spring electrode implants showed that spring mounted posts penetrated the retina, thus the device will be redesigned to reduce the strength of the springs. These initial implants will provide information for the designers to make the next generation silicon device. We conclude that microsystems technology has the potential to make possible a retinal prosthesis with 1000 individual contacts in close proximity to the retina.

  1. Patient-Specific Orthopaedic Implants.

    PubMed

    Haglin, Jack M; Eltorai, Adam E M; Gil, Joseph A; Marcaccio, Stephen E; Botero-Hincapie, Juliana; Daniels, Alan H

    2016-11-01

    Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy. Surgeons can then place these temporary guides or "jigs" during the procedure, allowing them to better recreate the exact resections of the computer-generated surgical plan. Over the past decade, patient-specific implants have seen increased use in orthopaedics and they have been widely indicated in total knee arthroplasty, total hip arthroplasty, and corrective osteotomies. Patient-specific implants have also been explored for use in total shoulder arthroplasty and spinal surgery. Despite their increasing popularity, significant support for PSI use in orthopaedics has been lacking in the literature and it is currently uncertain whether the theoretical biomechanical advantages of patient-specific orthopaedic implants carry true advantages in surgical outcomes when compared to standard procedures. The purpose of this review was to assess the current status of patient-specific orthopaedic implants, to explore their future direction, and to summarize any comparative published studies that measure definitive surgical characteristics of patient-specific orthopaedic implant use such as patient outcomes, biomechanical implant alignment, surgical cost, patient blood loss, or patient recovery.

  2. Implant platform switching: biomechanical approach using two-dimensional finite element analysis.

    PubMed

    Tabata, Lucas Fernando; Assunção, Wirley Gonçalves; Adelino Ricardo Barão, Valentim; de Sousa, Edson Antonio Capello; Gomes, Erica Alves; Delben, Juliana Aparecida

    2010-01-01

    In implant therapy, a peri-implant bone resorption has been noticed mainly in the first year after prosthesis insertion. This bone remodeling can sometimes jeopardize the outcome of the treatment, especially in areas in which short implants are used and also in aesthetic cases. To avoid this occurrence, the use of platform switching (PS) has been used. This study aimed to evaluate the biomechanical concept of PS with relation to stress distribution using two-dimensional finite element analysis. A regular matching diameter connection of abutment-implant (regular platform group [RPG]) and a PS connection (PS group [PSG]) were simulated by 2 two-dimensional finite element models that reproduced a 2-piece implant system with peri-implant bone tissue. A regular implant (prosthetic platform of 4.1 mm) and a wide implant (prosthetic platform of 5.0 mm) were used to represent the RPG and PSG, respectively, in which a regular prosthetic component of 4.1 mm was connected to represent the crown. A load of 100 N was applied on the models using ANSYS software. The RPG spreads the stress over a wider area in the peri-implant bone tissue (159 MPa) and the implant (1610 MPa), whereas the PSG seems to diminish the stress distribution on bone tissue (34 MPa) and implant (649 MPa). Within the limitation of the study, the PS presented better biomechanical behavior in relation to stress distribution on the implant but especially in the bone tissue (80% less). However, in the crown and retention screw, an increase in stress concentration was observed.

  3. Load fatigue performance of conical implant-abutment connections.

    PubMed

    Seetoh, Y L; Tan, Keson B; Chua, E K; Quek, H C; Nicholls, Jack I

    2011-01-01

    Conical implant-abutment connections for platform switching have been recently introduced in implant systems. This study investigated the load fatigue performance of three conical abutment systems and their corresponding titanium and zirconia abutments. Regular-diameter implants of the Ankylos (AK), PrimaConnex (PC), and Straumann (ST) systems were tested with their corresponding titanium (Ti) and zirconia (Zr) abutments tightened to the recommended torque (n = 5 implant-abutment assemblies per group). A rotational load fatigue machine applied a sinusoidally varying tensile-compressive 21 N load to specimens at a 45-degree angle, producing an effective bending moment of 35 Ncm at a frequency of 10 Hz. The number of cycles to failure was recorded, with the upper limit set at 5 million cycles. Results were evaluated through analyses of variance. Except for the ST Zr group, which showed no failures in four samples and one failure just below the screw head, and the AK Ti group, in which one sample was preserved without fracture, all groups experienced failure of at least one of the components, whether the abutment screw only, the abutment, and/or the implant neck. There were significant differences between systems. There was no difference between systems for the Ti abutments, and the ST group was significantly different from the AK and PC groups for the Zr abutments. Ti conical abutments appear to have poorer load fatigue performance compared with earlier studies of external-hexagon connections. The load fatigue performance of Zr conical abutments varied and seemed to be highly system dependent. Many of the fractures in both the Ti and Zr abutment groups occurred within the implant, and retrieval would pose a significant clinical challenge. The clinician should weigh the mechanical, biologic, and esthetic considerations before selection of any implant system, connection type, or abutment material.

  4. Modelling dental implant extraction by pullout and torque procedures.

    PubMed

    Rittel, D; Dorogoy, A; Shemtov-Yona, K

    2017-07-01

    Dental implants extraction, achieved either by applying torque or pullout force, is used to estimate the bone-implant interfacial strength. A detailed description of the mechanical and physical aspects of the extraction process in the literature is still missing. This paper presents 3D nonlinear dynamic finite element simulations of a commercial implant extraction process from the mandible bone. Emphasis is put on the typical load-displacement and torque-angle relationships for various types of cortical and trabecular bone strengths. The simulations also study of the influence of the osseointegration level on those relationships. This is done by simulating implant extraction right after insertion when interfacial frictional contact exists between the implant and bone, and long after insertion, assuming that the implant is fully bonded to the bone. The model does not include a separate representation and model of the interfacial layer for which available data is limited. The obtained relationships show that the higher the strength of the trabecular bone the higher the peak extraction force, while for application of torque, it is the cortical bone which might dictate the peak torque value. Information on the relative strength contrast of the cortical and trabecular components, as well as the progressive nature of the damage evolution, can be revealed from the obtained relations. It is shown that full osseointegration might multiply the peak and average load values by a factor 3-12 although the calculated work of extraction varies only by a factor of 1.5. From a quantitative point of view, it is suggested that, as an alternative to reporting peak load or torque values, an average value derived from the extraction work be used to better characterize the bone-implant interfacial strength. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Male chest enhancement: pectoral implants.

    PubMed

    Benito-Ruiz, J; Raigosa, J M; Manzano-Surroca, M; Salvador, L

    2008-01-01

    The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries.

  6. [Considerations for optimizing joint implants].

    PubMed

    Tensi, H M; Orloff, S; Gese, H; Hooputra, H

    1994-09-01

    Despite the increasing use of orthopaedic implants, there is still a lack of adequate testing procedures and legal guidelines. Examples of the consequences of this neglect are given. Modern techniques for the calculation of stresses (finite element method [FEM]) and the prediction of life cycle duration are presented. Such methods, applied in the development and manufacturing phases of standard and special implants, may ensure an adequate prosthetic life cycle, with particular emphasis being placed on the biomedical optimization of the implant/bone interface and surrounding bone.

  7. Maxillomandibular relationship record for implant complete mouth rehabilitation with elastomeric material and facial surface index of existing denture.

    PubMed

    Patil, Pravinkumar G; Nimbalkar-Patil, Smita

    2015-01-01

    The maxillomandibular relationship (MMR) record is a critical step to establish the new occlusion in implant supported complete mouth rehabilitation. Using patients existing denture for recording the MMR requires implant definitive cast to be modified extensively to completely seat the denture (with unaltered flanges) on it. This may influence the correct seating of the denture on the implant definitive cast causing faulty recording of the MMR. Elastomeric record bases, reinforced with the resin framework, are fabricated and relined with the light body elastomeric material when all the healing abutments are in place. The MMR is recorded with these elastomeric record bases using vacuum formed facial surface index of the occluded existing dentures as a guideline. The elastomeric record bases with facial surface index of the existing dentures can allow clinicians to record MMR records without removing the healing abutments from the mouth with acceptable accuracy. This can save chair-side time of the procedure. The record of facial surfaces of existing complete denture in the form of vacuum formed sheet helps to set the occlusal vertical dimension. Use of facial surface index together with the elastomeric record bases can be the useful alternative technique to record the MMR in patients with implant supported full mouth rehabilitation. Further study is required to prove its routine clinical utility.

  8. Maxillomandibular relationship record for implant complete mouth rehabilitation with elastomeric material and facial surface index of existing denture

    PubMed Central

    Patil, Pravinkumar G.; Nimbalkar-Patil, Smita

    2015-01-01

    Introduction: The maxillomandibular relationship (MMR) record is a critical step to establish the new occlusion in implant supported complete mouth rehabilitation. Using patients existing denture for recording the MMR requires implant definitive cast to be modified extensively to completely seat the denture (with unaltered flanges) on it. This may influence the correct seating of the denture on the implant definitive cast causing faulty recording of the MMR. Materials and Method: Elastomeric record bases, reinforced with the resin framework, are fabricated and relined with the light body elastomeric material when all the healing abutments are in place. The MMR is recorded with these elastomeric record bases using vacuum formed facial surface index of the occluded existing dentures as a guideline. Results: The elastomeric record bases with facial surface index of the existing dentures can allow clinicians to record MMR records without removing the healing abutments from the mouth with acceptable accuracy. This can save chair-side time of the procedure. The record of facial surfaces of existing complete denture in the form of vacuum formed sheet helps to set the occlusal vertical dimension. Conclusion: Use of facial surface index together with the elastomeric record bases can be the useful alternative technique to record the MMR in patients with implant supported full mouth rehabilitation. Further study is required to prove its routine clinical utility. PMID:26929537

  9. Occlusion on oral implants: current clinical guidelines.

    PubMed

    Koyano, K; Esaki, D

    2015-02-01

    Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future.

  10. Accidental Implant Screwdriver Ingestion: A Rare Complication during Implant Placement

    PubMed Central

    Jain, Anshul; Baliga, Shridhar D

    2014-01-01

    One of the complications during a routine dental implant placement is accidental ingestion of the implant instruments, which can happen when proper precautions are not taken. Appropriate radiographs should be taken to locate the correct position of foreign body; usually the foreign body passes asymptomatically from gastrointestinal tract but sometimes it may lead to intestinal obstruction, perforations and impactions. The aim of this article is to report accidental ingestion of 19 mm long screw driver by a senile patient. PMID:25628702

  11. Implant retention systems for implant-retained overdentures.

    PubMed

    Laverty, D P; Green, D; Marrison, D; Addy, L; Thomas, M B M

    2017-03-10

    Implant retained overdentures are being increasingly utilised in both general and specialist practice to rehabilitate patients with missing teeth, particularly those that are edentate. This article aims to inform the reader of a variety of retention systems that are available to retain an implant overdenture and to understand how these systems work, their advantages and disadvantages and to outline some of the clinical and treatment planning considerations involved in selecting the most appropriate retention system for patients.

  12. Er + medium energy ion implantation into lithium niobate

    NASA Astrophysics Data System (ADS)

    Svecova, B.; Nekvindova, P.; Mackova, A.; Oswald, J.; Vacik, J.; Grötzschel, R.; Spirkova, J.

    2009-05-01

    Erbium-doped lithium niobate (Er:LiNbO3) is a prospective photonics component, operating at 1.5 μm, which could find its use chiefly as an optical amplifier or waveguide laser. In this study, we have focused on the properties of the optically active Er:LiNbO3 layers, which are fabricated by medium energy ion implantation under various experimental conditions. Erbium ions were implanted at energies of 330 and 500 keV with fluences of 1.0 × 1015, 2.5 × 1015 and 1.0 × 1016 cm-2 into LiNbO3 single-crystalline cuts of various orientations. The as-implanted samples were annealed in air at 350 °C for 5 h. The depth distribution and diffusion profiles of the implanted Er were measured by Rutherford Backscattering Spectroscopy (RBS) using 2 MeV He+ ions. The projected range RP and projected range straggling ΔRP were calculated employing the SRIM code. The damage distribution and structural changes were described using the RBS/channelling method. Changes of the lithium concentration depth distribution were studied by Neutron Depth Profiling (NDP). The photoluminescence spectra of the samples were measured to determine whether the emission was in the desired region of 1.5 μm. The obtained data made it possible to reveal the relations between the structural changes of erbium-implanted lithium niobate and its luminescence properties important for photonics applications.

  13. On the electrical conductivity of Ti-implanted alumina

    SciTech Connect

    Salvadori, M. C.; Teixeira, F. S.; Cattani, M.; Nikolaev, A.; Savkin, K. P.; Oks, E. M.; Park, H.-K.; Phillips, L.; Yu, K. M.; Brown, I. G.

    2012-03-15

    Ion implantation of metal species into insulators provides a tool for the formation of thin, electrically conducting, surface layers with experimenter-controlled resistivity. High energy implantation of Pt and Ti into alumina accelerator components has been successfully employed to control high voltage surface breakdown in a number of cases. In the work described here we have carried out some basic investigations related to the origin of this phenomenon. By comparison of the results of alumina implanted with Ti at 75 keV with the results of prior investigations of polymers implanted with Pt at 49 eV and Au at 67 eV, we describe a physical model of the effect based on percolation theory and estimate the percolation parameters for the Ti-alumina composite. We estimate that the percolation dose threshold is about 4 x 10{sup 16} cm{sup -2} and the maximum dose for which the system remains an insulator-conductor composite is about 10 x 10{sup 16} cm{sup -2}. The saturation electrical conductivity is estimated to be about 50 S/m. We conclude that the observed electrical conductivity properties of Ti-implanted alumina can be satisfactorily described by percolation theory.

  14. Dynamic MC simulation of low-energy ion implantation

    NASA Astrophysics Data System (ADS)

    Yamamura, Y.

    1999-06-01

    In order to investigate the ion fluence effect in the depth profiles of the dynamic Monte Carlo code, ACAT-DIFFUSE, is applied to the calculation of depth profiles due to low-energy B ion implantation, where 1 and 5 keV B ions are implanted into an amorphized silicon target. As the ion fluence increases, the dopant B atoms are accumulated in solids and the target must be considered as a two-component material composed of the original target atoms and trapped implanted ions. This results in the radiation-induced-diffusion and the self-sputtering of trapped implanted ions. It is found that the peak locations of the dopant B depth profiles at 1 keV B ion bombardment shifted to the surface due to radiation-induced diffusion as ion increased and we observe the near-the-surface enhancement in the dopant B depth profiles due to 5 keV B ion bombardment. The self-sputtering also becomes important with increasing ion fluence. The retention ratios of the implanted B atoms are about 0.89 and 0.94 for 1 and 5 keV B ions, respectively, at 3.0 × 10 13 B ions/cm 2.

  15. Working memory in Farsi-speaking children with normal development and cochlear implant.

    PubMed

    Soleymani, Zahra; Amidfar, Meysam; Dadgar, Hooshang; Jalaie, Shohre

    2014-04-01

    Working memory has an important role in language acquisition and development of cognition skills. The ability of encoding, storage and retrieval of phonological codes, as activities of working memory, acquired by audition sense. Children with cochlear implant experience a period that they are not able to perceive sounds. In order to assess the effect of hearing on working memory, we investigated working memory as a cognition skill in children with normal development and cochlear implant. Fifty students with normal hearing and 50 students with cochlear implant aged 5-7 years participated in this study. Children educated in the preschool, the first and second grades. Children with normal development were matched based on age, gender, and grade of education with cochlear implant. Two components of working memory including phonological loop and central executive were compared between two groups. Phonological loop assessed by nonword repetition task and forward digit span. To assess central executive component backward digit span was used. The developmental trend was studied in children with normal development and cochlear implant as well. The effect of age at implantation in children with cochlear implants on components of working memory was investigated. There are significant differences between children with normal development and cochlear implant in all tasks that assess working memory (p < 0.001). The children's age at implantation was negatively correlated with all tasks (p < 0.001). In contrast, duration of usage of cochlear implant set was positively correlated with all tasks (p < 0.001). The comparison of working memory between different grades showed significant differences both in children with normal development and in children with cochlear implant (p < 0.05). These results implied that children with cochlear implant may experience difficulties in working memory. Therefore, these children have problems in encoding, practicing, and repeating phonological

  16. Improved accuracy of computer assisted glenoid implantation in total shoulder arthroplasty: an in-vitro randomized controlled trial.

    PubMed

    Nguyen, Duong; Ferreira, Louis M; Brownhill, James R; King, Graham J W; Drosdowech, Darren S; Faber, Kenneth J; Johnson, James A

    2009-01-01

    Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this study was to evaluate a computer-assisted technique to achieve a more accurate placement of the glenoid component compared to traditional techniques. Sixteen paired cadaveric shoulders were randomized to either traditional or computer-assisted glenoid implantation. Preoperative planning consisting of CT scanning with 3-dimensional image modeling of the shoulder specimens and intraoperative tracking with real-time feedback provided to the surgeon was employed in the computer-assisted group. A validated, previously published, standardized protocol for tracking the orientation of the glenoid in space using 3 glenoid surface landmarks was employed. All phases of glenoid implantation (initial guide pin insertion, reaming, drilling of the peg holes, and final component implantation) were tracked and recorded by the computer. A post-implantation CT scan was performed in both groups to compare how accurately the implants were placed. The computer-assisted technique was more accurate in achieving the correct version during all phases of glenoid implantation and as measured on the post-implantation CT scan (P < .05). The largest errors with traditional glenoid implantation were observed during drilling and, more so, during reaming. The trend was to overly retrovert the glenoid. Computer assisted navigation results in a more accurate glenoid component placement relative to traditional techniques. Basic Science Study.

  17. Rehabilitation of malpositioned implants with a CAD/CAM milled implant overdenture: a clinical report.

    PubMed

    Moeller, Mauricio S; Duff, Renee E; Razzoog, Michael E

    2011-03-01

    Dentists may be faced with the challenge of restoring unfavorably placed implants. In some instances, previously integrated implants may be from different manufacturers. This clinical report describes the rehabilitation of a patient with a maxillary CAD/CAM implant bar-supported overdenture that presented with malpositioned implants, from different manufacturers, including one from a discontinued implant system.

  18. Safety of Outpatient Implantation of the Implantable Cardioverter-defibrillator.

    PubMed

    Datino, Tomás; Miracle Blanco, Ángel; Núñez García, Alberto; González-Torrecilla, Esteban; Atienza Fernández, Felipe; Arenal Maíz, Ángel; Hernández-Hernández, Jesús; Ávila Alonso, Pablo; Eidelman, Gabriel; Fernández-Avilés, Francisco

    2015-07-01

    Strategies are needed to reduce health care costs and improve patient care. The objective of our study was to analyze the safety of outpatient implantation of cardioverter-defibrillators. A retrospective study was conducted in 401 consecutive patients who received an implantable cardioverter-defibrillator between 2007 and 2012. The rate of intervention-related complications was compared between 232 patients (58%) whose implantation was performed in the outpatient setting and 169 patients (42%) whose intervention was performed in the inpatient setting. The mean age (standard deviation) of the patients was 62 (14) years; 336 (84%) were male. Outpatients had lower left ventricular ejection fraction and a higher percentage had an indication for primary prevention of sudden death, compared to inpatients. Only 21 outpatients (9%) required subsequent hospitalization. The rate of complications until the third month postimplantation was similar for outpatients (6.0%) and inpatients (5.3%); P = .763. In multivariate analysis, only previous anticoagulant therapy was related to the presence of complications (odds ratio = 3.2; 95% confidence interval, 1.4-7.4; P < .01), mainly due to an increased rate of pocket hematomas. Each outpatient implantation saved approximately €735. Outpatient implantation of implantable cardioverter-defibrillators is safe and reduces costs. Close observation is recommended for patients receiving chronic anticoagulation therapy due to an increased risk of complications. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Techniques for Processing Eyes Implanted with a Retinal Prosthesis for Localized Histopathological Analysis: Part 2 Epiretinal Implants with Retinal Tacks

    PubMed Central

    Nayagam, David A.X.; Durmo, Irfan; McGowan, Ceara; Williams, Richard A.; Shepherd, Robert K.

    2015-01-01

    Retinal prostheses for the treatment of certain forms of blindness are gaining traction in clinical trials around the world with commercial devices currently entering the market. In order to evaluate the safety of these devices, in preclinical studies, reliable techniques are needed. However, the hard metal components utilised in some retinal implants are not compatible with traditional histological processes, particularly in consideration for the delicate nature of the surrounding tissue. Here we describe techniques for assessing the health of the eye directly adjacent to a retinal implant secured epiretinally with a metal tack. Retinal prostheses feature electrode arrays in contact with eye tissue. The most commonly used location for implantation is the epiretinal location (posterior chamber of the eye), where the implant is secured to the retina with a metal tack that penetrates all the layers of the eye. Previous methods have not been able to assess the proximal ocular tissue with the tack in situ, due to the inability of traditional histological techniques to cut metal objects. Consequently, it has been difficult to assess localized damage, if present, caused by tack insertion. Therefore, we developed a technique for visualizing the tissue around a retinal tack and implant. We have modified an established technique, used for processing and visualizing hard bony tissue around a cochlear implant, for the soft delicate tissues of the eye. We orientated and embedded the fixed eye tissue, including the implant and retinal tack, in epoxy resin, to stabilise and protect the structure of the sample. Embedded samples were then ground, polished, stained, and imaged under various magnifications at incremental depths through the sample. This technique allowed the reliable assessment of eye tissue integrity and cytoarchitecture adjacent to the metal tack. PMID:25798628

  20. Techniques for processing eyes implanted with a retinal prosthesis for localized histopathological analysis: Part 2 Epiretinal implants with retinal tacks.

    PubMed

    Nayagam, David A X; Durmo, Irfan; McGowan, Ceara; Williams, Richard A; Shepherd, Robert K

    2015-02-14

    Retinal prostheses for the treatment of certain forms of blindness are gaining traction in clinical trials around the world with commercial devices currently entering the market. In order to evaluate the safety of these devices, in preclinical studies, reliable techniques are needed. However, the hard metal components utilised in some retinal implants are not compatible with traditional histological processes, particularly in consideration for the delicate nature of the surrounding tissue. Here we describe techniques for assessing the health of the eye directly adjacent to a retinal implant secured epiretinally with a metal tack. Retinal prostheses feature electrode arrays in contact with eye tissue. The most commonly used location for implantation is the epiretinal location (posterior chamber of the eye), where the implant is secured to the retina with a metal tack that penetrates all the layers of the eye. Previous methods have not been able to assess the proximal ocular tissue with the tack in situ, due to the inability of traditional histological techniques to cut metal objects. Consequently, it has been difficult to assess localized damage, if present, caused by tack insertion. Therefore, we developed a technique for visualizing the tissue around a retinal tack and implant. We have modified an established technique, used for processing and visualizing hard bony tissue around a cochlear implant, for the soft delicate tissues of the eye. We orientated and embedded the fixed eye tissue, including the implant and retinal tack, in epoxy resin, to stabilise and protect the structure of the sample. Embedded samples were then ground, polished, stained, and imaged under various magnifications at incremental depths through the sample. This technique allowed the reliable assessment of eye tissue integrity and cytoarchitecture adjacent to the metal tack.

  1. Miniscrew implant applications in contemporary orthodontics.

    PubMed

    Chang, Hong-Po; Tseng, Yu-Chuan

    2014-03-01

    The need for orthodontic treatment modalities that provide maximal anchorage control but with minimal patient compliance requirements has led to the development of implant-assisted orthodontics and dentofacial orthopedics. Skeletal anchorage with miniscrew implants has no patient compliance requirements and has been widely incorporated in orthodontic practice. Miniscrew implants are now routinely used as anchorage devices in orthodontic treatment. This review summarizes recent data regarding the interpretation of bone data (i.e., bone quantity and quality) obtained by preoperative diagnostic computed tomography (CT) or by cone-beam computed tomography (CBCT) prior to miniscrew implant placement. Such data are essential when selecting appropriate sites for miniscrew implant placement. Bone characteristics that are indications and contraindications for treatment with miniscrew implants are discussed. Additionally, bicortical orthodontic skeletal anchorage, risks associated with miniscrew implant failure, and miniscrew implants for nonsurgical correction of occlusal cant or vertical excess are reviewed. Finally, implant stability is compared between titanium alloy and stainless steel miniscrew implants.

  2. Intraoral Digital Impressioning for Dental Implant Restorations Versus Traditional Implant Impression Techniques.

    PubMed

    Wilk, Brian L

    2015-01-01

    Over the course of the past two to three decades, intraoral digital impression systems have gained acceptance due to high accuracy and ease of use as they have been incorporated into the fabrication of dental implant restorations. The use of intraoral digital impressions enables the clinician to produce accurate restorations without the unpleasant aspects of traditional impression materials and techniques. This article discusses the various types of digital impression systems and their accuracy compared to traditional impression techniques. The cost, time, and patient satisfaction components of both techniques will also be reviewed.

  3. Radiographic determinants of implant performance.

    PubMed

    Reddy, M S; Wang, I C

    1999-06-01

    This paper reviews and compares the strengths and weaknesses of radiographic techniques including periapical, occlusal, panoramic, direct digital, motion tomography, and computed tomography. Practical considerations for each method, including availability and accessibility, are discussed. To date, digital subtraction radiography is the most versatile and sensitive method for measuring boss loss. It can detect both bone height and bone mass changes on root-form or blade-form dental implants. Criteria for implant success have changed substantially over the past two decades. In clinical trials of dental implants, the outcomes require certain radiographic analyses to address the hypothesis or clinical question adequately. Radiographic methods best suited to the objective assessment of implant performance and hypothesis were reviewed.

  4. Implants for draining neovascular glaucoma.

    PubMed Central

    Molteno, A C; Van Rooyen, M M; Bartholomew, R S

    1977-01-01

    The implant design, surgical technique, and pharmacological methods of controlling bleb fibrosis, used to treat neovascular glaucoma, are described, together with the results of 14 operations performed on 12 eyes. Images PMID:843508

  5. [Implantation in severe myopia cataract].

    PubMed

    Metge, P; Ginestet, X; Morin, B; Platon, O

    1989-01-01

    Based upon biometric and statistical analysis of 163 eyes (26 mm or longer), it appears that high myopia cataract occur all the earlier as the eye is long; on average, these were operated on ten years earlier than cataracts in the general population. Extra-capsular extraction and intercapsular implantation were generally used. Pre and post-operative complications are remarkably rare for such abnormal eyes. After a mean period of 22 months, detachment of the retina was observed in 1.84% of patients and secondary capsulotomy performed in 8%. Because they prevent secondary capsular opacification and anterior vitreous propagation, it appears that such barrier-type implants should be systematically placed. Current large-diameter implants allow for vitreoretinal observation. Based upon this patient population, a formula for implant power calculation specific to high myopia has been elaborated. The desired degree of refraction varies with age and patient activity.

  6. Advances in lens implant technology

    PubMed Central

    Kampik, Anselm; Dexl, Alois K.; Zimmermann, Nicole; Glasser, Adrian; Baumeister, Martin; Kohnen, Thomas

    2013-01-01

    Cataract surgery is one of the oldest and the most frequent outpatient clinic operations in medicine performed worldwide. The clouded human crystalline lens is replaced by an artificial intraocular lens implanted into the capsular bag. During the last six decades, cataract surgery has undergone rapid development from a traumatic, manual surgical procedure with implantation of a simple lens to a minimally invasive intervention increasingly assisted by high technology and a broad variety of implants customized for each patient’s individual requirements. This review discusses the major advances in this field and focuses on the main challenge remaining – the treatment of presbyopia. The demand for correction of presbyopia is increasing, reflecting the global growth of the ageing population. Pearls and pitfalls of currently applied methods to correct presbyopia and different approaches under investigation, both in lens implant technology and in surgical technology, are discussed. PMID:23413369

  7. Breast Implants: Saline vs. Silicone

    MedlinePlus

    ... be inserted at the same time. If an MRI scan detects an implant rupture but you don't ... require additional, specialized views. You might need routine MRI scans. The Food and Drug Administration recommends monitoring silicone ...

  8. [Imaging in silicone breast implantation].

    PubMed

    Gielens, Maaike P M; Koolen, Pieter G L; Hermens, Roland A E C; Rutten, Matthieu J C M

    2013-01-01

    Recently, there have been concerns regarding the use of breast implants from Poly Implant Prothèse (PIP, Seyne sur Mer, France) for breast augmentation due to their tendency to rupture and the possibility of having toxic contents. MRI using a specific silicone-sensitive sequence has proven to be the most sensitive and specific technique in the detection of intra- and extracapsular implant rupture. However, given its high costs, it is important that this technique is used sparingly. In this clinical lesson, we compare the sensitivity and specificity of mammography, ultrasound, CT and MRI for the detection of breast implant rupture. Based on two cases, a diagnostic approach is given in order to reduce health care costs.

  9. New tools for sculpting cranial implants in a shared haptic augmented reality environment.

    PubMed

    Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

    2006-01-01

    New volumetric tools were developed for the design and fabrication of high quality cranial implants from patient CT data. These virtual tools replace time consuming physical sculpting, mold making and casting steps. The implant is designed by medical professionals in tele-immersive collaboration. Virtual clay is added in the virtual defect area on the CT data using the adding tool. With force feedback the modeler can feel the edge of the defect and fill only the space where no bone is present. A carving tool and a smoothing tool are then used to sculpt and refine the implant. To make a physical evaluation, the skull with simulated defect and the implant are fabricated via stereolithography to allow neurosurgeons to evaluate the quality of the implant. Initial tests demonstrate a very high quality fit. These new haptic volumetric sculpting tools are a critical component of a comprehensive tele-immersive system.

  10. Integration of Digital Dentistry into a Predoctoral Implant Program: Program Description, Rationale, and Utilization Trends.

    PubMed

    Afshari, Fatemeh S; Sukotjo, Cortino; Alfaro, Maria F; McCombs, Jeri; Campbell, Stephen D; Knoernschild, Kent L; Yuan, Judy Chia-Chun

    2017-08-01

    A recently revised predoctoral implant curriculum at the University of Illinois at Chicago College of Dentistry integrated digital dentistry into both the preclinical dental implant course and clinical activities. Traditionally, competence in the didactic and clinical parts of predoctoral education in single tooth implant restorations has emphasized the analog impression technique and subsequent mounting of soft tissue working casts. However, computer-aided design/computer-aided manufacturing (CAD/CAM) implant restorations can play a significant role in predoctoral dental education utilizing digital technologies. The goal of the curriculum expansion is to transition from analog to partially digital and, finally, complete digital workflow. The aim of this article is to describe the specific components, implementation, and rationale for the new digitally integrated implant curriculum and present short-term clinical utilization trends.

  11. "Peri-Implantitis": A Complication of a Foreign Body or a Man-Made "Disease". Facts and Fiction.

    PubMed

    Albrektsson, Tomas; Canullo, Luigi; Cochran, David; De Bruyn, Hugo

    2016-08-01

    The discrepancy between some scientific views and the daily clinical experience with dental implants has made the topic of "periimplantitis" highly controversial, especially the discussion whether "periimplantitis" should even be considered a "disease" or whether marginal bone loss instead would represent a complication of having a foreign body placed in the oral cavity. The aim of the present paper was to present the outcomes from a consensus meeting on "peri-implantitis" in Rome, Italy (January 8-10, 2016). Seventeen clinical scientists were invited to, based on prepared reviews of the literature, discuss topics related to "periimplantitis." Oral implants may lose bone or even display clinical failure. However, progressive bone loss threatening implant survival is rare and limited to a percent or two of all implants followed up over 10 years or more, provided that controlled implant systems are being used by properly trained clinicians. There is very little evidence pointing to implants suffering from a defined disease entity entitled "peri-implantitis." Marginal bone loss around implants is in the great majority of cases associated with immune-osteolytic reactions. Complicating factors include patient genetic disorders, patient smoking, cement or impression material remnants in the peri-implant sulcus, bacterial contamination of the implant components and technical issues such as loose screws, mobile components or fractured materials. These reactions combine to result in cellular responses with the end result being a shift in the delicate balance between the osteoblast and the osteoclast resulting in bone resorption. However, the great majority of controlled implants display a foreign body equilibrium resulting in very high survival rates of the implants over long term of follow-up. © 2016 Wiley Periodicals, Inc.

  12. Surgical Tooth Implants, Combat and Field.

    DTIC Science & Technology

    1984-07-15

    and identify by block number) --- This Annual Report summarizes progress to date on a long-term implant study of a serrated ceramic dental implant...upper two parts of the implant, post and core and crown, are conventional metaT materials. A series of graded dental implants have been produced to...throughout the experimental period. Periodic radio- graphic analyses of dental implants verify this observation. Gross and microscopic patho- logic analyses

  13. Surgical Tooth Implants, Combat and Field.

    DTIC Science & Technology

    1985-11-15

    development of dental implantology must not be overlooked. The early stages of this project clearly defined that rigid fixation of an implant device...block number) .-... This report summarizes progress on a long-ter implant study of a serrated ceramic dental implant designed for fresh extraction...implant, post and core and crown, are conventional metal materials, A series of graded dental implants have been produced to provide an interference fit

  14. Biocompatibility of radiolucent breast implants.

    PubMed

    Young, V L; Lund, H; Destouet, J; Pidgeon, L; Ueda, K

    1991-09-01

    Current implants for breast augmentation containing silicone gel, saline, or both are radiopaque on mammographic examination and can totally obscure microcalcifications and soft-tissue masses. The effect of these implants on the detection of early breast cancers in patients who have undergone augmentation mammaplasty remains unproven and controversial. Implants filled with medium-chain triglycerides (peanut oil) are radiolucent on mammographic examination and allow visualization of both soft-tissue masses and microcalcifications. To investigate the biocompatibility of radiolucent implants, 10 cc of sterile, nonpyrogenic peanut oil was injected subcutaneously into rats using silicone gel as a control. Twenty-one rabbits had two 125-cc silicone shell implants inserted on either side of the chest wall. The right-sided shell was filled with 125 cc of sterile saline, and the left-sided shell was filled with 125 cc of sterile, nonpyrogenic peanut oil. Results were determined by both histologic and radiographic examination. Rats injected with peanut oil equivalent to 7 percent of their body weight rapidly absorbed the freely injected oil without detriment. Histologic examination of the lungs, liver, kidneys, and tissues adjacent to the injection sites demonstrated no abnormalities. There was no evidence of allergic, toxic, inflammatory, or neoplastic response. Eighteen of 21 rabbits survived more than 3 months. Radiographs showed the oil-filled implants to be radiolucent, whereas the saline-filled controls obscured the surrounding soft and bony tissues. Histologic examination demonstrated a fibrous capsule surrounding both types of implants. Histologic examination of the lungs, liver, and kidneys showed no significant abnormalities. These and previous studies have shown peanut oil to be biocompatible when freely injected either intramuscularly or subcutaneously. This study demonstrates that a radiolucent, peanut oil-filled implant is biocompatible in animals and that

  15. Implant-related nerve injuries.

    PubMed

    Steinberg, Mark J; Kelly, Patrick D

    2015-04-01

    Injuries to branches of the trigeminal nerves are a known complication during dental implant placement. These injuries tend to be more severe than those experienced during other dentoalveolar procedures. This article reviews the types of nerve injuries and areas and situations of which clinicians should be cognizant when placing dental implants. Strategies to avoid injuries, and a management algorithm for suspected nerve injuries, are also discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Cochlear implants in young children.

    PubMed

    Niparko, John K; Blankenhorn, Rebecca

    2003-01-01

    The cochlear implant is best characterized as a device that provides access to the sound environment. The device enables the hearing pathway to respond to environmental and speech sounds, providing informational cues from the surroundings and from others that may escape visual detection. As the developmental effects of a profound hearing loss are multiple, cochlear implants have been applied to ever younger children in an attempt to promote a more normal level of developmental learning through audition. In deafness, transducer elements of the inner ear fail to trigger auditory nerve afferent nerves in the presence of sound input. However, large reserves of afferent fibers exist even in the auditory nerve of a profoundly deaf patient. Furthermore, these nerve fibers retain the ability to respond to prosthetic activation. Through developmental learning in the early, formative years, auditory centers of the brain appear capable of processing information from the implant to provide speech comprehension and oral language development. Multichannel implants have replaced original single channel designs. multichannel devices enable larger percentages of recipients to recognize the spoken word without visual cues because they provide spectral information in addition to temporal and intensity cues. Testing under conditions of auditory (implant)-only input reveals significant open-set speech understanding capabilities in more than 75% of children after three years of device use. The benefit provided by implants may vary with a number of conditions including: hearing history, age of deafness onset, age at implantation, etiology of deafness, linguistic abilities, and the presence of a motivated system of support of oral language development. Patient variables should be given individual consideration in judging candidacy for a cochlear implant and in planning rehabilitative and education services after surgery and activation of the device. Copyright 2003 Wiley-Liss, Inc.

  17. [Guidelines for nursing methodology implantation].

    PubMed

    Alberdi Castell, Rosamaría; Artigas Lelong, Berta; Cuxart Ainaud, Núria; Agüera Ponce, Ana

    2003-09-01

    The authors introduce three guidelines as part of the process to implant the nursing methodology based on the Virginia Henderson Conceptual Model; they propose to help nurses adopt the aforementioned method in their daily practice. These three guidelines shall be published in successive articles: Guidelines to identify attitudes and aptitudes related to the nursing profession; Guidelines to implant the nursing methodology based on the Virginia Henderson Conceptual Model; and Guidelines to plan areas for improvement.

  18. The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty: A Biomechanical Model Using Digital Image Correlation.

    PubMed

    Ali, A M; Newman, S D S; Hooper, P A; Davies, C M; Cobb, J P

    2017-08-01

    Unicompartmental knee arthroplasty (UKA) is a demanding procedure, with tibial component subsidence or pain from high tibial strain being potential causes of revision. The optimal position in terms of load transfer has not been documented for lateral UKA. Our aim was to determine the effect of tibial component position on proximal tibial strain. A total of 16 composite tibias were implanted with an Oxford Domed Lateral Partial Knee implant using cutting guides to define tibial slope and resection depth. Four implant positions were assessed: standard (5° posterior slope); 10° posterior slope; 5° reverse tibial slope; and 4 mm increased tibial resection. Using an electrodynamic axial-torsional materials testing machine (Instron 5565), a compressive load of 1.5 kN was applied at 60 N/s on a meniscal bearing via a matching femoral component. Tibial strain beneath the implant was measured using a calibrated Digital Image Correlation system. A 5° increase in tibial component posterior slope resulted in a 53% increase in mean major principal strain in the posterior tibial zone adjacent to the implant (p = 0.003). The highest strains for all implant positions were recorded in the anterior cortex 2 cm to 3 cm distal to the implant. Posteriorly, strain tended to decrease with increasing distance from the implant. Lateral cortical strain showed no significant relationship with implant position. Relatively small changes in implant position and orientation may significantly affect tibial cortical strain. Avoidance of excessive posterior tibial slope may be advisable during lateral UKA.Cite this article: A. M. Ali, S. D. S. Newman, P. A. Hooper, C. M. Davies, J. P. Cobb. The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty: A Biomechanical Model Using Digital Image Correlation. Bone Joint Res 2017;6:522-529. DOI: 10.1302/2046-3758.68.BJR-2017-0067.R1. © 2017 Ali et al.

  19. Nanostructured surfaces of dental implants.

    PubMed

    Bressan, Eriberto; Sbricoli, Luca; Guazzo, Riccardo; Tocco, Ilaria; Roman, Marco; Vindigni, Vincenzo; Stellini, Edoardo; Gardin, Chiara; Ferroni, Letizia; Sivolella, Stefano; Zavan, Barbara

    2013-01-17

    The structural and functional fusion of the surface of the dental implant with the surrounding bone (osseointegration) is crucial for the short and long term outcome of the device. In recent years, the enhancement of bone formation at the bone-implant interface has been achieved through the modulation of osteoblasts adhesion and spreading, induced by structural modifications of the implant surface, particularly at the nanoscale level. In this context, traditional chemical and physical processes find new applications to achieve the best dental implant technology. This review provides an overview of the most common manufacture techniques and the related cells-surface interactions and modulation. A Medline and a hand search were conducted to identify studies concerning nanostructuration of implant surface and their related biological interaction. In this paper, we stressed the importance of the modifications on dental implant surfaces at the nanometric level. Nowadays, there is still little evidence of the long-term benefits of nanofeatures, as the promising results achieved in vitro and in animals have still to be confirmed in humans. However, the increasing interest in nanotechnology is undoubted and more research is going to be published in the coming years.

  20. Clinical experiences with dental implants.

    PubMed

    Henry, P J

    1999-06-01

    The clinical utilization of dental implants has accelerated in recent years, and new applications continue to emerge. Concomitantly, alternative implant systems have introduced conceptually different approaches to treatment using altered protocols. The purpose of this paper is to address some of the background issues pertinent to the long-term success, survival, safety, and effectiveness of these devices. The requirements for clinical acceptance of implants are controlled initially by regulatory bodies; however, the dentist eventually must make a decision on which type of implant should be used in clinical practice. This clinical decision-making process should involve the strategy of using an evidence-based approach to ensure quality of care and reduction of liability for negligent care. This is particularly the case when treatment is undertaken in identified high-risk categories. While short- to medium-term data have been accumulated on the success rates of several implant systems, it is apparent that long-term data comparing and contrasting the various advantages and disadvantages of different systems do not exist, and adequate criteria applicable to the collective clinical experience need to be defined. Expanding areas of application are dependent on continuous improvements in implant hardware, surgical protocol development, and rationalized osteopromotive and site installation augmentation technology. Many treatment endeavors are still largely at the pilot study level of development, and long-term prospective clinical trials on large numbers of patients are required to document results adequately and to elucidate the most likely productive areas for future investigation.

  1. Ceramic-coated implant systems.

    PubMed

    Meffert, R M

    1999-06-01

    Practitioners have used hydroxyapatite-coated (HA-coated) endosseous and subperiosteal implants in various forms for many years. These have included root forms in both screw and cylindrical shapes, blades, and subperiosteals. The clinical predictability remains controversial and subject to claims and counterclaims. The early days of dental implantology involving root-form implants recommended their placement in fully edentulous cases only, and anterior to the maxillary sinus and mental foramen. Today's philosophy and rationale of dental implantology include the placement of a single implant replacing a missing natural tooth (especially where the teeth adjacent to the edentulous site have no caries or restorative experience). Implants are used to replace the natural dentition in one quadrant/segment, often preceded or accompanied by ridge augmentation and/or sinus grafting if sufficient bone is not present. So we have to address the clinical predictability of survival in terms of indications, quantity, and quality of bone. Clinical data and experience suggest that hydroxyapatite-coated (HA) dental implants may (and possibly should) be used in (1) Type IV bone, (2) fresh extraction sites, (3) grafted maxillary and/or nasal sinuses, or (4) with short implants (< or = 10 mm in length).

  2. Ion implanted dielectric elastomer circuits

    NASA Astrophysics Data System (ADS)

    O'Brien, Benjamin M.; Rosset, Samuel; Anderson, Iain A.; Shea, Herbert R.

    2013-06-01

    Starfish and octopuses control their infinite degree-of-freedom arms with panache—capabilities typical of nature where the distribution of reflex-like intelligence throughout soft muscular networks greatly outperforms anything hard, heavy, and man-made. Dielectric elastomer actuators show great promise for soft artificial muscle networks. One way to make them smart is with piezo-resistive Dielectric Elastomer Switches (DES) that can be combined with artificial muscles to create arbitrary digital logic circuits. Unfortunately there are currently no reliable materials or fabrication process. Thus devices typically fail within a few thousand cycles. As a first step in the search for better materials we present a preliminary exploration of piezo-resistors made with filtered cathodic vacuum arc metal ion implantation. DES were formed on polydimethylsiloxane silicone membranes out of ion implanted gold nano-clusters. We propose that there are four distinct regimes (high dose, above percolation, on percolation, low dose) in which gold ion implanted piezo-resistors can operate and present experimental results on implanted piezo-resistors switching high voltages as well as a simple artificial muscle inverter. While gold ion implanted DES are limited by high hysteresis and low sensitivity, they already show promise for a range of applications including hysteretic oscillators and soft generators. With improvements to implanter process control the promise of artificial muscle circuitry for soft smart actuator networks could become a reality.

  3. Retinal implants: a systematic review.

    PubMed

    Chuang, Alice T; Margo, Curtis E; Greenberg, Paul B

    2014-07-01

    Retinal implants present an innovative way of restoring sight in degenerative retinal diseases. Previous reviews of research progress were written by groups developing their own devices. This systematic review objectively compares selected models by examining publications describing five representative retinal prostheses: Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Publications were analysed using three criteria for interim success: clinical availability, vision restoration potential and long-term biocompatibility. Clinical availability: Argus II is the only device with FDA approval. Argus II and Alpha-IMS have both received the European CE Marking. All others are in clinical trials, except the Boston Retinal Implant, which is in animal studies. Vision restoration: resolution theoretically correlates with electrode number. Among devices with external cameras, the Boston Retinal Implant leads with 100 electrodes, followed by Argus II with 60 electrodes and visual acuity of 20/1262. Instead of an external camera, Alpha-IMS uses a photodiode system dependent on natural eye movements and can deliver visual acuity up to 20/546. Long-term compatibility: IMI offers iterative learning; Epi-Ret 3 is a fully intraocular device; Alpha-IMS uses intraocular photosensitive elements. Merging the results of these three criteria, Alpha-IMS is the most likely to achieve long-term success decades later, beyond current clinical availability.

  4. Auditory Midbrain Implant: A Review

    PubMed Central

    Lim, Hubert H.; Lenarz, Minoo; Lenarz, Thomas

    2009-01-01

    The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented. PMID:19762428

  5. Cochlear implants and medical tourism.

    PubMed

    McKinnon, Brian J; Bhatt, Nishant

    2010-09-01

    To compare the costs of medical tourism in cochlear implant surgery performed in India as compared to the United States. In addition, the cost savings of obtaining cochlear implant surgery in India were compare d to those of other surgical interventions obtained as a medical tourist. Searches were conducted on Medline and Google using the search terms: 'medical tourism', 'medical offshoring', 'medical outsourcing', 'cochlear implants' and 'cochlear implantation'. The information regarding cost of medical treatment was obtained from personal communication with individuals familiar with India's cochlear implantation medical tourism industry. The range of cost depended on length of stay as well as the device chosen. Generally the cost, inclusive of travel, surgery and device, was in the range of $21,000-30,000, as compared to a cost range of $40,000-$60,000 in the US. With the escalating cost of healthcare in the United States, it is not surprising that some patients would seek to obtain surgical care overseas at a fraction of the cost. Participants in medical tourism often have financial resources, but lack health insurance coverage. While cardiovascular and orthopedic surgery performed outside the United States in India at centers that cater to medical tourists are often performed at one-quarter to one-third of the cost that would have been paid in the United States, the cost differential for cochlear implants is not nearly as favorable.

  6. Biomechanics of Corneal Ring Implants

    PubMed Central

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. Results: For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. Conclusions: The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus. PMID:26312619

  7. Therapy using implanted organic bioelectronics

    PubMed Central

    Jonsson, Amanda; Song, Zhiyang; Nilsson, David; Meyerson, Björn A.; Simon, Daniel T.; Linderoth, Bengt; Berggren, Magnus

    2015-01-01

    Many drugs provide their therapeutic action only at specific sites in the body, but are administered in ways that cause the drug’s spread throughout the organism. This can lead to serious side effects. Local delivery from an implanted device may avoid these issues, especially if the delivery rate can be tuned according to the need of the patient. We turned to electronically and ionically conducting polymers to design a device that could be implanted and used for local electrically controlled delivery of therapeutics. The conducting polymers in our device allow electronic pulses to be transduced into biological signals, in the form of ionic and molecular fluxes, which provide a way of interfacing biology with electronics. Devices based on conducting polymers and polyelectrolytes have been demonstrated in controlled substance delivery to neural tissue, biosensing, and neural recording and stimulation. While providing proof of principle of bioelectronic integration, such demonstrations have been performed in vitro or in anesthetized animals. Here, we demonstrate the efficacy of an implantable organic electronic delivery device for the treatment of neuropathic pain in an animal model. Devices were implanted onto the spinal cord of rats, and 2 days after implantation, local delivery of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) was initiated. Highly localized delivery resulted in a significant decrease in pain response with low dosage and no observable side effects. This demonstration of organic bioelectronics-based therapy in awake animals illustrates a viable alternative to existing pain treatments, paving the way for future implantable bioelectronic therapeutics. PMID:26601181

  8. Damage annealing in low temperature Fe/Mn implanted ZnO

    NASA Astrophysics Data System (ADS)

    Gunnlaugsson, H. P.; Bharuth-Ram, K.; Johnston, K.; Langouche, G.; Mantovan, R.; Mølholt, T. E.; Naidoo, D.; Ólafsson, O.; Weyer, G.

    2015-04-01

    57Fe Emission Mössbauer spectra obtained after low fluence (<1012 cm -2) implantation of 57Mn ( T 1/2= 1.5 min.) into ZnO single crystal held at temperatures below room temperature (RT) are presented. The spectra can be analysed in terms of four components due to Fe 2+ and Fe 3+ on Zn sites, interstitial Fe and Fe in damage regions (Fe D ). The Fe D component is found to be indistinguishable from similar component observed in emission Mössbauer spectra of higher fluence (˜1015 cm -2)57Fe/ 57Co implanted ZnO and 57Fe implanted ZnO, demonstrating that the nature of the damage regions in the two types of experiments is similar. The defect component observed in the low temperature regime was found to anneal below RT.

  9. Dental implant management and maintenance: How to improve long-term implant success?

    PubMed

    Clark, Danielle; Levin, Liran

    2016-01-01

    Although dental implants are proven to be a predictable longterm treatment for patients, it is important to realize that not all implants that survive are necessarily successful. Successful implants are those that remain fully functional and healthy within the oral cavity. Peri-implantitis is a disease that is associated with implant failure, and is becoming rather prevalent. Assessing risk factors and stabilizing existing oral disease prior to the placement of implants will aid in preventing implant disease and failure. After implant placement, a strict follow-up regime with a dental professional should be implemented in order to monitor the implant and surrounding teeth for disease. The dental professional should continually encourage the patient to adhere to consistent homecare to prevent peri-implantitis from occurring, and in turn increase the success of their implants. Early diagnosis and elimination of inflammatory processes around the implants will improve the longterm prognosis as well.

  10. Imaging of common breast implants and implant-related complications: A pictorial essay.

    PubMed

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer.

  11. Why are mini-implants lost: The value of the implantation technique!

    PubMed Central

    Romano, Fabio Lourenço; Consolaro, Alberto

    2015-01-01

    The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss. PMID:25741821

  12. Why are mini-implants lost: the value of the implantation technique!

    PubMed

    Romano, Fabio Lourenço; Consolaro, Alberto

    2015-01-01

    The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

  13. Laser-Modified Surface Enhances Osseointegration and Biomechanical Anchorage of Commercially Pure Titanium Implants for Bone-Anchored Hearing Systems

    PubMed Central

    Omar, Omar; Simonsson, Hanna; Palmquist, Anders; Thomsen, Peter

    2016-01-01

    Osseointegrated implants inserted in the temporal bone are a vital component of bone-anchored hearing systems (BAHS). Despite low implant failure levels, early loading protocols and simplified procedures necessitate the application of implants which promote bone formation, bone bonding and biomechanical stability. Here, screw-shaped, commercially pure titanium implants were selectively laser ablated within the thread valley using an Nd:YAG laser to produce a microtopography with a superimposed nanotexture and a thickened surface oxide layer. State-of-the-art machined implants served as controls. After eight weeks’ implantation in rabbit tibiae, resonance frequency analysis (RFA) values increased from insertion to retrieval for both implant types, while removal torque (RTQ) measurements showed 153% higher biomechanical anchorage of the laser-modified implants. Comparably high bone area (BA) and bone-implant contact (BIC) were recorded for both implant types but with distinctly different failure patterns following biomechanical testing. Fracture lines appeared within the bone ~30–50 μm from the laser-modified surface, while separation occurred at the bone-implant interface for the machined surface. Strong correlations were found between RTQ and BIC and between RFA at retrieval and BA. In the endosteal threads, where all the bone had formed de novo, the extracellular matrix composition, the mineralised bone area and osteocyte densities were comparable for the two types of implant. Using resin cast etching, osteocyte canaliculi were observed directly approaching the laser-modified implant surface. Transmission electron microscopy showed canaliculi in close proximity to the laser-modified surface, in addition to a highly ordered arrangement of collagen fibrils aligned parallel to the implant surface contour. It is concluded that the physico-chemical surface properties of laser-modified surfaces (thicker oxide, micro- and nanoscale texture) promote bone bonding

  14. Laser-Modified Surface Enhances Osseointegration and Biomechanical Anchorage of Commercially Pure Titanium Implants for Bone-Anchored Hearing Systems.

    PubMed

    Shah, Furqan A; Johansson, Martin L; Omar, Omar; Simonsson, Hanna; Palmquist, Anders; Thomsen, Peter

    2016-01-01

    Osseointegrated implants inserted in the temporal bone are a vital component of bone-anchored hearing systems (BAHS). Despite low implant failure levels, early loading protocols and simplified procedures necessitate the application of implants which promote bone formation, bone bonding and biomechanical stability. Here, screw-shaped, commercially pure titanium implants were selectively laser ablated within the thread valley using an Nd:YAG laser to produce a microtopography with a superimposed nanotexture and a thickened surface oxide layer. State-of-the-art machined implants served as controls. After eight weeks' implantation in rabbit tibiae, resonance frequency analysis (RFA) values increased from insertion to retrieval for both implant types, while removal torque (RTQ) measurements showed 153% higher biomechanical anchorage of the laser-modified implants. Comparably high bone area (BA) and bone-implant contact (BIC) were recorded for both implant types but with distinctly different failure patterns following biomechanical testing. Fracture lines appeared within the bone ~30-50 μm from the laser-modified surface, while separation occurred at the bone-implant interface for the machined surface. Strong correlations were found between RTQ and BIC and between RFA at retrieval and BA. In the endosteal threads, where all the bone had formed de novo, the extracellular matrix composition, the mineralised bone area and osteocyte densities were comparable for the two types of implant. Using resin cast etching, osteocyte canaliculi were observed directly approaching the laser-modified implant surface. Transmission electron microscopy showed canaliculi in close proximity to the laser-modified surface, in addition to a highly ordered arrangement of collagen fibrils aligned parallel to the implant surface contour. It is concluded that the physico-chemical surface properties of laser-modified surfaces (thicker oxide, micro- and nanoscale texture) promote bone bonding which

  15. Reasons for failures of oral implants.

    PubMed

    Chrcanovic, B R; Albrektsson, T; Wennerberg, A

    2014-06-01

    This study reviews the literature regarding the factors contributing to failures of dental implants. An electronic search was undertaken including papers from 2004 onwards. The titles and abstracts from these results were read to identify studies within the selection criteria. All reference lists of the selected studies were then hand-searched, this time without time restrictions. A narrative review discussed some findings from the first two parts where separate data from non-comparative studies may have indicated conclusions different from those possible to draw in the systematic analysis. It may be suggested that the following situations are correlated to increase the implant failure rate: a low insertion torque of implants that are planned to be immediately or early loaded, inexperienced surgeons inserting the implants, implant insertion in the maxilla, implant insertion in the posterior region of the jaws, implants in heavy smokers, implant insertion in bone qualities type III and IV, implant insertion in places with small bone volumes, use of shorter length implants, greater number of implants placed per patient, lack of initial implant stability, use of cylindrical (non-threaded) implants and prosthetic rehabilitation with implant-supported overdentures. Moreover, it may be suggested that the following situations may be correlated with an increase in the implant failure rate: use of the non-submerged technique, immediate loading, implant insertion in fresh extraction sockets, smaller diameter implants. Some recently published studies suggest that modern, moderately rough implants may present with similar results irrespective if placed in maxillas, in smoking patients or using only short implants.

  16. Effects of crown retrieval on implants and the surrounding bone: a finite element analysis.

    PubMed

    Ozkir, Serhat Emre; Unal, Server Mutluay; Yurekli, Emel; Güven, Sedat

    2016-04-01

    The aim of this study was to observe stress concentration in the implant, the surrounding bone, and other components under the pull-out force during the crown removal. Two 3-dimensional models of implant-supported conventional metal ceramic crowns were digitally constructed. One model was designed as a vertically placed implant (3.7 mm × 10 mm) with a straight abutment, and the other model was designed as a 30-degree inclined implant (3.7 mm × 10 mm) with an angled abutment. A pull-out force of 40 N was applied to the crown. The stress values were calculated within the dental implant, the abutment, the abutment screw, and the surrounding bone. The highest stress concentration was observed at the coronal portion of the straight implant (9.29 MPa). The stress concentrations at the cortical bone were lower than at the implants, and maximum stress concentration in bone structure was 1.73 MPa. At the abutment screws, the stress concentration levels were similiar (3.09 MPa and 3.44 MPa), but the localizations were different. The stress at the angled abutment was higher than the stress at the straight abutment. The pull-out force, applied during a crown removal, did not show an evident effect in bone structure. The higher stress concentrations were mostly observed at the implant and the abutment collar. In addition, the abutment screw, which is the weakest part of an implant system, also showed stress concentrations. Implant angulation affected the stress concentration levels and localizations. These results will help clinicians understand the mechanical behavior of cement-retained implant-supported crowns during crown retrieval.

  17. Effects of crown retrieval on implants and the surrounding bone: a finite element analysis

    PubMed Central

    Unal, Server Mutluay; Yurekli, Emel; Güven, Sedat

    2016-01-01

    PURPOSE The aim of this study was to observe stress concentration in the implant, the surrounding bone, and other components under the pull-out force during the crown removal. MATERIALS AND METHODS Two 3-dimensional models of implant-supported conventional metal ceramic crowns were digitally constructed. One model was designed as a vertically placed implant (3.7 mm × 10 mm) with a straight abutment, and the other model was designed as a 30-degree inclined implant (3.7 mm × 10 mm) with an angled abutment. A pull-out force of 40 N was applied to the crown. The stress values were calculated within the dental implant, the abutment, the abutment screw, and the surrounding bone. RESULTS The highest stress concentration was observed at the coronal portion of the straight implant (9.29 MPa). The stress concentrations at the cortical bone were lower than at the implants, and maximum stress concentration in bone structure was 1.73 MPa. At the abutment screws, the stress concentration levels were similiar (3.09 MPa and 3.44 MPa), but the localizations were different. The stress at the angled abutment was higher than the stress at the straight abutment. CONCLUSION The pull-out force, applied during a crown removal, did not show an evident effect in bone structure. The higher stress concentrations were mostly observed at the implant and the abutment collar. In addition, the abutment screw, which is the weakest part of an implant system, also showed stress concentrations. Implant angulation affected the stress concentration levels and localizations. CLINICAL IMPLICATIONS These results will help clinicians understand the mechanical behavior of cement-retained implant-supported crowns during crown retrieval. PMID:27141257

  18. Implant Removal After Internal Fixation of a Femoral Neck Fracture: Effects on Physical Functioning.

    PubMed

    Zielinski, Stephanie M; Heetveld, Martin J; Bhandari, Mohit; Patka, Peter; Van Lieshout, Esther M M

    2015-09-01

    The effect of implant removal after internal fixation of a femoral neck fracture on physical functioning was analyzed. Characteristics of patients who had their implant removed were studied, as it is currently unknown from which type of patients implants are removed and what effect removal has on function. Secondary cohort study alongside a randomized controlled trial. Multicenter study in 14 hospitals. Patients who had their implant removed after internal fixation of a femoral neck fracture are compared with patients who did not. Patient characteristics and quality of life (Short Form 12, Western Ontario McMaster Osteoarthritis Index) were compared. Matched pairs were selected based on patient/fracture characteristics and prefracture physical functioning. Of 162 patients, 37 (23%) had their implant removed. These patients were younger (median age: 67 vs. 72 years, P = 0.024) and more often independently ambulatory prefracture (100% vs. 84%, P = 0.008) than patients who did not. They more often had evident implant back-out on x-rays (54% vs. 34%, P = 0.035), possibly related to a higher rate of Pauwels 3 fractures (41% vs. 22%, P = 0.032). In time, quality of life improved more in implant removal patients [+2 vs. -4 points, Short Form 12 (physical component), P = 0.024; +9 vs. 0 points, Western Ontario McMaster Osteoarthritis Index, P = 0.019]. Implant removal after internal fixation of a femoral neck fracture positively influenced quality of life. Implant removal patients were younger and more often independently ambulatory prefracture, more often had a Pauwels 3 fracture, and an evident implant back-out. Implant removal should be considered liberally for these patients if pain persists or functional recovery is unsatisfactory. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  19. Implant maintenance treatment and peri-implant health.

    PubMed

    Howe, Mark-Steven

    2017-03-01

    Data sourcesMedline (PubMed), Embase, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases and a manual search of the Journal of Dental Research, Journal of Clinical Periodontology, Journal of Periodontology and the International Journal of Periodontics and Restorative Dentistry from January 2014 to February 2015.Study selectionProspective, retrospective, randomised or not, case-controlled or case series trials showing the incidence or recurrence of peri-implant disease plus or minus PIMT over more than six months.Data extraction and synthesisThree reviewers independently selected studies and abstracted data with two reviewers assessing study quality using the Newcastle-Ottawa Scale (NOS). A multivariate binomial regression was used to examine the data.ResultsThirteen studies were included with ten contributing to the meta-analysis. The average quality assessment score (NOS) was 5.3 out of a possible nine, only one paper achieved eight. At patient level mucositis ranged from 18.5-74.2% and peri-implantitis from 8-28%, with significant effects being seen for treatment (z= -14.36, p<0.001). Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. For peri-implantitis there were also significant effects of treatment (z = -16.63, p<0.001). Increased peri-implantitis was observed for patients with a history of periodontal disease. (z=3.76, p<0.001). Implants under PIMT have 0.958 the incident event compared to those with no PIMT.ConclusionsWithin the limitations of the present systematic review it can be concluded that implant therapy must not be limited to placement and restoration of dental implants, but to the implementation of PIMT to potentially prevent biological complications and heighten the long-term success rate. Although it must be tailored to a patients risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of five to six

  20. Implantable multichannel wireless electromyography for prosthesis control.

    PubMed

    McDonnall, Daniel; Hiatt, Scott; Smith, Christopher; Guillory, K Shane

    2012-01-01

    We have developed a prototype implantable device for recording multiple independent channels of EMG and sending those signals wirelessly to an external receiver. This design records multichannel EMG signals for providing simultaneous multi-axis control of prosthetic limbs. This proof-of-concept study demonstrates benchtop performance of the bioamplifier in dry and soaked in saline configurations, as well as system performance in a short-term in vivo study in six dogs. The amplifier was shown to have an input-referred noise of 2.2 µV(RMS), a common mode rejection ratio greater than 55 dB, and neighboring channel isolation averaging 66 dB. The prototype devices were constructed of an amplifier ASIC along with discrete components for wireless function. These devices were coated in silicone and implanted for at least one week in each dog. EMG recorded from each animal as it walked down a hallway had very low noise and swing/stance phases of gait were clearly shown. This study demonstrates this device design can be used to amplify and transmit muscle signals.

  1. Methods of Hearing Preservation during Cochlear Implantation.

    PubMed

    Khater, Ahmed; El-Anwar, Mohammad Waheed

    2017-07-01

    Introduction  Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives  The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis  We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery. We fully read about 15 studies that met the criteria described in "study selection". The studies showed that several factors could contribute to possible cochlear damage during or after CI surgery and must be kept in mind; mechanical damage during electrode insertion, shock waves in the perilymph fluid due to implantation, acoustic trauma due to drilling, loss of perilymph and disruption of inner ear fluid homeostasis, potential bacterial infection, and secondary intracochlear fibrous tissue formation. The desire to preserve residual hearing has led to the development of the soft-surgery protocols with its various components; avoiding entry of blood into the cochlea and the use of hyaluronate seem to be reasonably supported, whereas the use of topical steroids is questionable. The site of entry into the cochlea, electrode design, and the depth of insertion are also important contributing factors. Conclusion  Hearing preservation would be useful for CI patients to benefit from the residual low frequency, as well as for the children who could be candidate for future regenerative hair cell therapy.

  2. Plasma-Ion Processing of Three-Dimensional Components

    SciTech Connect

    Yukimura, Ken; Wei Ronghua

    2004-12-01

    Plasma-based ion implantation and deposition (PBII and D) technology has been developed rapidly in the past decade. This technique is especially promising for modifying three-dimensional components. In PBII and D, plasma is generated in the entire processing chamber and then surrounds the components. When a train of negative voltage pulses are applied to the parts, ions are drawn to all the surfaces exposed to the plasma. At a high energy, ions are implanted to the surfaces, but at a low energy and with a proper precursor gases, ions are deposited to form a film. This technology has found applications in many areas including semiconductors, automotive, aerospace, energy and biomedical. This article reviews PBII and D fundamentals, describes features of various PBII and D systems and plasma sources, and discusses implantation and deposition techniques. The paper will also present application examples of this technology.

  3. Ion-beam-sputter modification of the surface morphology of biological implants

    NASA Technical Reports Server (NTRS)

    Weigand, A. J.; Banks, B. A.

    1977-01-01

    The surface chemistry and texture of materials used for biological implants may significantly influence their performance and biocompatibility. Recent interest in the microscopic control of implant surface texture has led to the evaluation of ion-beam sputtering as a potentially useful surface roughening technique. Ion sources, similar to electron-bombardment ion thrusters designed for propulsive applications, are used to roughen the surfaces of various biocompatible alloys or polymer materials. These materials are typically used for dental implants, orthopedic prostheses, vascular prostheses, and artificial heart components. Masking techniques and resulting surface textures are described along with progress concerning evaluation of the biological response to the ion-beam-sputtered surfaces.

  4. Ion beam sputter modification of the surface morphology of biological implants

    NASA Technical Reports Server (NTRS)

    Weigand, A. J.; Banks, B. A.

    1976-01-01

    The surface chemistry and texture of materials used for biological implants may significantly influence their performance and biocompatibility. Recent interest in the microscopic control of implant surface texture has led to the evaluation of ion beam sputtering as a potentially useful surface roughening technique. Ion sources, similar to electron bombardment ion thrusters designed for propulsive applications, are used to roughen the surfaces of various biocompatible alloys or polymer materials. These materials are typically used for dental implants, orthopedic prostheses, vascular prostheses, and artificial heart components. Masking techniques and resulting surface textures are described along with progress concerning evaluation of the biological response to the ion beam sputtered surfaces.

  5. Ion-beam-sputter modification of the surface morphology of biological implants

    NASA Technical Reports Server (NTRS)

    Weigand, A. J.; Banks, B. A.

    1977-01-01

    The surface chemistry and texture of materials used for biological implants may significantly influence their performance and biocompatibility. Recent interest in the microscopic control of implant surface texture has led to the evaluation of ion-beam sputtering as a potentially useful surface roughening technique. Ion sources, similar to electron-bombardment ion thrusters designed for propulsive applications, are used to roughen the surfaces of various biocompatible alloys or polymer materials. These materials are typically used for dental implants, orthopedic prostheses, vascular prostheses, and artificial heart components. Masking techniques and resulting surface textures are described along with progress concerning evaluation of the biological response to the ion-beam-sputtered surfaces.

  6. The peri-implantitis: implant surfaces, microstructure, and physicochemical aspects.

    PubMed

    Mouhyi, Jaafar; Dohan Ehrenfest, David M; Albrektsson, Tomas

    2012-04-01

    There are two ways of looking at secondary failures of osseointegration; one is to reflect on possible causes for the failure, the other focuses on the pathology per se. In the first case, background factors such as mechanical trauma (adverse loading) or inflammations/infections are being discussed as the cause of failure. Then peri-implantitis is a term reserved for implant disturbance due to inflammation/infections only. However, irrespective of the original reason for the failure being adverse loading or inflammation/infection, the end result with bone resorption and inflammation may be very similar. Hence, in the present article, an alternative outlook has been chosen. Trigerring factors for peri-implantitis are generally gathered under four categories: lesions of peri-implant attachment, presence of aggressive bacteria, excessive mechanical stress, and corrosion. If only one of these factors would start a chain reaction leading to lesions, then the other factors may combine to worsen the condition. With other words, peri-implantitis is a general term dependent on a synergy of several factors, irrespective of the precise reason for first triggering off symptoms. © 2009 Wiley Periodicals, Inc.

  7. Gold-coated pacemaker implantation for a patient with type IV allergy to titanium

    PubMed Central

    Kypta, Alexander; Blessberger, Hermann; Lichtenauer, Michael; Lambert, Thomas; Kammler, Juergen; Steinwender, Clemens

    2016-01-01

    A 65-year-old man was scheduled for pacemaker implantation for symptomatic sick-sinus-syndrome (SSS). He suffered from multiple drug-allergies and allergies to several metals like quicksilver and titanium. Gold-coated pacemaker generators and polyurethane leads are effective in avoiding allergic reactions to pacing system components. Therefore, we decided to implant a custom-made gold-coated DDDR-pacemaker generator and polyurethane leads. PMID:27479204

  8. Combustion Synthesis of Ca3(PO4)2 Net-Shape Surgical Implants

    NASA Technical Reports Server (NTRS)

    Ayers, Reed A.; Castillo, Martin; Gottoli, Guglielmo; Moore, John J.; Simske, Steven J.

    2006-01-01

    Self-propagating high-temperature combustion synthesis (SHS) is the basis of a method of making components of porous tricalcium phosphate [Ca3(PO4)2] and related compounds in net sizes and shapes for use as surgical implants that are compatible with bone. The SHS method offers advantages over prior methods of manufacturing Ca3(PO4)2-based surgical implants.

  9. How we do it: adaptation of music instruction for pediatric cochlear implant recipients.

    PubMed

    Hsiao, Fei-Lin; Gfeller, Kate

    2011-11-01

    This paper outlines the skills required for participation in structured music programs and possible adaptations to facilitate successful participation by pediatric cochlear implant recipients. Common curricular components that present the structural features of music and the implications for perceptual and music production skills are discussed. A checklist of practical recommendations for clinicians, educators, and parents is provided to ensure success in integrating cochlear implant recipients into early childhood music programs.

  10. Engineered PlyCB as a Novel Implant Coating for Osseointegration

    DTIC Science & Technology

    2012-03-01

    The lack of osseointegration is the primary cause of implant failure or shortened lifespan under physiological loads. Coatings such as hydroxyapatite ...the mineral component of bone, are often used to promote integration of bone with implant. However, hydroxyapatite coatings do not contain any...protein, was found to have a particularly high affinity for hydroxyapatite (Nelson, 2006). Based on the crystal structure, we plan to introduce mutants

  11. Peri-implant mucositis and peri-implantitis: clinical and histopathological characteristics and treatment.

    PubMed

    Khammissa, R A G; Feller, L; Meyerov, R; Lemmer, J

    2012-04-01

    Osseointegrated dental implants are used routinely in dentistry in the confidence of predictable success. However, if the implant surfaces become colonised by pathogenic bacteria, the plaque-induced inflammation around the implants may cause peri-implant tissue destruction. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit and clinically is characterised by redness, swelling and bleeding on gentle probing. Peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant: it is characterised by loss of osseointegration of the coronal part of the implant, by increased probing depth and by bleeding and/or suppuration on probing. Established peri-implantitis does not respond predictably to treatment. The best management of plaque-induced peri-implant inflammatory diseases is prevention. Regular personal and professional cleaning of the implant is mandatory to minimise bacterial load. Despite our best efforts, plaque-induced peri-implant inflammatory diseases will occur frequently, and as these diseases respond best to early treatment, early detection of peri-implant mucositis by regular assessment will permit timely treatment. Peri-implant mucositis is readily treated non-surgically. Peri-implantitis is more difficult to treat largely because of the problem of decontamination of the roughened, threaded surfaces of exposed implants. As a rule, surgical treatment will be necessary, and even then success is not assured.

  12. Effects of Cultured Adrenal Chromaffin Cell Implants on Hindlimb Reflexes of the 6-OHDA Lesioned Rat

    PubMed Central

    Pulford, Bruce E.; Mihajlov, Andrea R.; Nornes, Howard O.; Whalen, L. Ray

    1994-01-01

    The effects of implantation of cultured adrenal medullary cells on the recovery of neurotransmitter specific reflex activity were studied in the rat spinal cord using electrophysiological testing methods. Cell suspensions of cultured neonatal adrenal medullary chromaffin (AM) cells (which produce catecholamines), or Schwann (Sc) cells (controls) were implanted into the lumbar region of the spinal cord 2 weeks after catecholamine (CA) denervation by intracisternal injection of 6-hydroxydopamine (6-OHDA). All cells were taken from 7 day neonates and cultured for 10 days in the presence of nerve growth factor (NGF). Three months after implantation, the extent of implant-associated recovery of reflex activity was determined by measuring electromyogram (EMG) activity and force associated with the long latency component of the hindlimb withdrawal reflex (which is CA modulated). After the electrophysiological testing, rats were anesthetized, and the spinal cords were rapidly removed and frozen. Spinal cords were sectioned longitudinally, and implanted cells were visualized using glyoxylic acid techniques. Labelled sections were examined to determine cell survival. Results indicate that 1) chromaffin cells survive for 3 months in the segments of the cord into which they have been implanted and 2) rats implanted with AM cells have significantly more forceful withdrawal reflexes than those that received Sc cells or received no implant after lesioning. PMID:7703294

  13. Long-range effect of ion implantation of Raex and Hardox steels

    NASA Astrophysics Data System (ADS)

    Budzyński, P.; Kamiński, M.; Droździel, A.; Wiertel, M.

    2016-09-01

    Ion implantation involves introduction of ionized atoms of any element (nitrogen) to metals thanks to the high kinetic energy that they acquired in the electric field. The distribution of nitrogen ions implanted at E = 65 keV energy and D = 1.1017 N+ /cm2 fluence in the steel sample and vacancies produced by them was calculated using the SRIM program. This result was confirmed by RBS measurements. The initial maximum range of the implanted nitrogen ions is ∼⃒0.17 μm. This value is relatively small compared to the influence of nitriding on the thickness surface layer of modified steel piston rings. Measurements of the friction coefficient during the pin-on-disc tribological test were performed under dry friction conditions. The friction coefficient of the implanted sample increased to values characteristic of an unimplanted sample after ca. 1500 measurement cycles. The depth of wear trace is ca. 2.4 μm. This implies that the thickness of the layer modified by the implantation process is ∼⃒2.4 μm and exceeds the initial range of the implanted ions by an order of magnitude. This effect, referred to as a long-range implantation effect, is caused by migration of vacancies and nitrogen atoms into the sample. This phenomenon makes ion implantation a legitimate process of modification of the surface layer in order to enhance the tribological properties of critical components of internal combustion engines such as steel piston rings.

  14. Wear resistance of highly cross-linked and remelted polyethylenes after ion implantation and accelerated ageing.

    PubMed

    Medel, F J; Puértolas, J A

    2008-08-01

    Ion implantation may provide medical polyethylenes with excellent mechanical and tribological properties, helping to lower the risk of long-term osteolysis. Highly crosslinked and remelted polyethylenes, materials currently used as soft components in artificial joints, were implanted with N+ and He+ ions at different ion fluences. The mechanical and tribological properties under distilled water lubrication at body temperature were assessed after ion implantation by means of microhardness and pin-on-disc tests respectively. Thus, the influences of the ionic species and implantation dose on surface hardness, friction coefficient, and wear factor were fully characterized. Furthermore, the tribological behaviour was evaluated after an accelerated ageing protocol (120 degrees C for 36h). Ion implantation increased the surface hardness, as well as friction coefficients, and decreased the wear factors especially at the highest doses. Also, even though all artificially aged materials showed a worse wear behaviour, polyethylenes implanted with either N+ or He+ at the highest doses maintained a relatively good wear factor in comparison with the aged non-implanted material. The origins of these modifications are discussed according to the effects of ion implantation on the microstructure of the polymer.

  15. Parameters for successful implant integration revisited part II: algorithm for immediate loading diagnostic factors.

    PubMed

    Bahat, Oded; Sullivan, Richard M

    2010-05-01

    Immediate loading of dental implants has become a widely reported practice with success rates ranging from 70.8% to 100%. Although most studies have considered implant survival to be the only measure of success, a better definition includes the long-term stability of the hard and soft tissues around the implant(s) and other adjacent structures, as well as the long-term stability of all the restorative components. The parameters identified in 1981 by Albrektsson and colleagues as influencing the establishment and maintenance of osseointegration have been reconsidered in relation to immediate loading to improve the chances of achieving such success. Two of the six parameters (status of the bone/implant site and implant loading conditions) have preoperative diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may compensate for less-than-ideal site and loading conditions. Factors affecting the outcome of immediate loading are reviewed to assist clinicians attempting to assess its risks and benefits.

  16. Use of stress analysis methods to evaluate the biomechanics of oral rehabilitation with implants.

    PubMed

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; Filho, Humberto Gennari; Monteiro, Douglas Roberto; Santos, Daniela Micheline Dos; Haddad, Marcela Filié; Pellizzer, Eduardo Piza

    2014-04-01

    Because the biomechanical behavior of dental implants is different from that of natural tooth, clinical problems may occur. The mechanism of stress distribution and load transfer to the implant/bone interface is a critical issue affecting the success rate of implants. Therefore, the aim of this study was to conduct a brief literature review of the available stress analysis methods to study implant-supported prosthesis loading and to discuss their contributions in the biomechanical evaluation of oral rehabilitation with implants. Several studies have used experimental, analytical, and computational models by means of finite element models (FEM), photoelasticity, strain gauges and associations of these methods to evaluate the biomechanical behavior of dental implants. The FEM has been used to evaluate new components, configurations, materials, and shapes of implants. The greatest advantage of the photoelastic method is the ability to visualize the stresses in complex structures, such as oral structures, and to observe the stress patterns in the whole model, allowing the researcher to localize and quantify the stress magnitude. Strain gauges can be used to assess in vivo and in vitro stress in prostheses, implants, and teeth. Some authors use the strain gauge technique with photoelasticity or FEM techniques. These methodologies can be widely applied in dentistry, mainly in the research field. Therefore, they can guide further research and clinical studies by predicting some disadvantages and streamlining clinical time.

  17. Investigation of a bioresorbable orbital implant.

    PubMed

    Jordan, David R; Brownstein, Seymour; Gilberg, Steve; Matthew, Benjamin; Mawn, Louise; Khouri, Lucie

    2002-09-01

    To analyze a new bioresorbable orbital implant (open-celled polylactic acid, also known as OPLA). The implants were examined macroscopically, with chemical analysis (Fourier transform infrared spectroscopy), and microscopically with scanning electron microscopy. Animal implantation of OPLA implants was carried out in 9 adult male New Zealand albino rabbits. Implant vascularization was evaluated by histopathologic sectioning. The OPLA implant is porous and lightweight but fragile. Histopathologically it stimulated primarily a multinucleated giant cell granulomatous reaction with little fibrovascular ingrowth seen at 4 and 8 weeks. By 20 and 24 weeks, the implant was replaced predominantly by necrotic debris and peripheral giant cells. The OPLA implant is not an acceptable alternative to other currently available orbital implants.

  18. Examination of failed retrieved temporomandibular joint (TMJ) implants.

    PubMed

    Kerwell, S; Alfaro, M; Pourzal, R; Lundberg, H J; Liao, Y; Sukotjo, C; Mercuri, L G; Mathew, M T

    2016-03-01

    In the management of end-stage temporomandibular joint disorders (TMD), surgeons must often resort to alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) to increase mandibular function and form, as well as reduce pain. Understanding wear and failure mechanisms of TMJ TJR implants is important to their in vivo longevity. However, compared to orthopedic TJR devices, functional wear of failed TMJ TJR implants has not been examined. Not only do wear and corrosion influence TJR implant in vivo longevity, but so does reactivity of peri-implant tissue to these two events. The aim of this study was to examine and report on the wear of retrieved, failed metal-on-metal (MoM), metal-on-polymer (MoP), and titanium-nitride coated (TiN Coated) TMJ TJR implant components. A total cohort of 31 TMJ TJR devices were studied of which 28 were failed, retrieved TMJ TJRs, 3 were never implanted devices that served as controls. The mean time from implantation to removal was 7.24 years (range 3-15), SD 3.01. Optical microscopy, White Light Interferometry (WLI), Scanning Electron Microscopy (SEM), and Raman spectroscopy were utilized to characterize the surfaces of the devices. Data was acquired and evaluated by analyzing alloy microstructure. Substantial surface damage was observed between the articulating areas of the condylar head and the glenoid fossa components. Damage included pitting corrosion, evidence of deposited corrosion products, specific wear patterns, hard phases, surface depressions, and bi-directional scratches. Electrochemical analysis was performed on the MoM Control, retrieved, failed MoM, and TiN Coated devices. Electrochemical tests consisted of open circuit potential (OCP) and electrochemical impedance spectroscopy (EIS) tests conducted using the condylar head of the retrieved failed devices. EIS confirmed material properties as well as corrosion kinetics in vivo help to mitigate corrosion as reflected by the Raman spectroscopy results. In

  19. Deuterium implantation in magnetic garnets

    SciTech Connect

    Wilts, C.H.; Urai, A.

    1988-11-01

    The magnetic effects of deuterium implantation and subsequent annealing were measured in Gd, Tm, and Ga-substituted yttrium iron garnet films for comparison with measurements made earlier with hydrogen implantation. Implantation energy was 60 keV and the dose ranged from 0.5 to 3 x 10/sup 16/ ions/cm/sup 2/ for D/sup +//sub 2/ ions, as compared to an energy of 120 keV and a dose from 0.3 to 4 x 10/sup 16/ ions/cm/sup 2/ for H/sup +//sub 2/ in the earlier study. Measurements made included x-ray rocking curves and ferromagnetic resonance spectra measured at 9.5 GHz. For all doses the implanted layer remained crystalline. Implanted layer thickness was about 4200 A and peak strain occured at a depth of 2600 A. Peak strain increased monotonically, but departed from a linear relation with dose. For the highest dose, the peak strain was 2.5%. Relaxation of strain with annealing was intermediate between that found earlier for hydrogen and neon implantation. As compared to all other implant elements, both deuterium and hydrogen show a large anomalous magnetic anisotropy which can exceed 10 000 Oe for either ion. The absence of this effect for He, Ne, and other ions supports the conjecture that the effect is chemical and related to electronic bonding rather than strain or disorder. The anomalous anisotropy for deuterium decreases and shifts location with annealing. It has largely disappeared at temperatures of 300--350 /sup 0/C. The shape of the profile is consistent with the hypothesis that the shift in anisotropy is associated with diffusion of the deuterium atoms to the surface of the garnet film. At the highest dose, crystalline damage in the region of highest strain is sufficient to radically alter magnetic properties and in particular reduces even the excess anisotropy so that a two-peak profile results until modified by annealing.

  20. An investigation of heat transfer to the implant-bone interface related to exothermic heat generation during setting of autopolymerizing acrylic resins applied directly to an implant abutment.

    PubMed

    Ormianer, Z; Laufer, B Z; Nissan, J; Gross, M

    2000-01-01

    Excessive heat generation at the implant-bone interface may cause bone damage and compromise osseointegration. Autopolymerizing acrylic resins are commonly used intraorally to join impression copings and suprastructure components for soldering. The effect of heat generation at the implant surface related to the exothermic setting reaction of autopolymerizing acrylic resins applied to an attached abutment was examined in vitro. Two brands of autopolymerizing acrylic resin, Duralay and GC Pattern Resin, were compared. Acrylic resin was applied to a titanium alloy abutment connected to a titanium alloy cylindric implant in varying controlled volumes, with both bulk application and brush paint-on techniques. The implant was embedded in an acrylic resin mandible in a 37 degrees C water bath. Temperature changes were recorded via embedded thermocouples at the cervical and apical of the implant surface. Analysis of variance for repeated measures was used to compare treatment groups. A mean maximum increase in temperature of 4 to 5 degrees C was seen at the implant cervical for both materials, with a maximum temperature increase of 6 degrees C. No difference between Duralay and GC Pattern Resin was seen, except for bulk application to medium-sized copper bands at the implant cervical (P < .05). No difference between the bulk and brush techniques was seen for all options, except for GC, where bulk application to medium-sized copper bands produced higher temperatures than the brush technique (P < .05). Spray coolant reduced temperatures for bulk application of both Duralay and GC (P < .05).

  1. High Density Ion Implanted Contiguous Disk Bubble Technology.

    DTIC Science & Technology

    1987-10-31

    wall motion Depending on the type of device being studied, the forces in (1) may arise from externally applied fields, permalloy propagation elements...the applied bias field, 2) the charged wall, 3) the edge- affinity due to the implanted/unimplanted boundary and, 4) conductors used to activate...c, H and H denote the Z components of the applied .V . 6 " field and the demagnetizing field originating from surface pole density averaged over the

  2. Three dimensional finite element analysis of a novel osteointegrated dental implant designed to reduce stress peak of cortical bone.

    PubMed

    Zheng, Li; Yang, Jingsong; Hu, Xuefeng; Luo, Jiaoming

    2014-01-01

    A new type of dental implant was designed as multi-component mainly including inset and abutment between which a gap was introduced to guide the force to transmit from the cancellous bone to cortical bone, with the intention to lower the stress peak at cortical bone. By way of finite element analysis (FEA) associated with advanced computer tomography (CT) and 3D model reconstruction technology to construct precise mandible model, biomechanical aspects of implant were investigated. Compared with traditional implant that created stress dominantly at cortical bone, stress peak at the implant/bone interface in the cervical cortex decreased sharply (about 51%) for the new type of implant. Furthermore, applying varying implant shape and gap dimensions helped to optimize the design of this new implant. Optimization results revealed that: (1) screwed cylindrical implant is superior to tapered, stepped and smooth cylindrical implant in effectively decreasing the stress peak of bone; (2) deepening and widening gap would contribute to the decline of stress peak, but at the cost of break and destruction of the inset; (3) suitable gap size with the depth of 7 mm and width of 0.3 mm would be applicable. This work may provide reference for clinical application of dental implant.

  3. Surgical and prosthodontic consequences of inadequate treatment planning for fixed implant-supported prosthesis in the edentulous mandible.

    PubMed

    Bidra, Avinash S

    2010-10-01

    Treatment planning for mandibular fixed implant-supported prostheses requires close communication between surgeons and restorative dentists. Improper implant positioning can result in significant difficulty for patient comfort and fabrication of a functional prosthesis. This case report describes the consequences of placing implants with no preoperative planning with regard to the implant position based on the final restorative plan. A 46-year-old male had all of his remaining maxillary and mandibular teeth extracted, and had 5 implants placed immediately in the interforaminal region of the mandible with the intent of providing a fixed prosthesis. Six weeks later, the patient was referred for prosthodontic care. The patient had no prostheses at that time and was in severe pain due to impingement of the lower lip by one of the implants. The implants were deemed to be in unfavorable positions and angulations. Thereafter, the case was treatment-planned systematically, requiring 2 additional surgical procedures---removal of one of the implants and alveoloplasty of posterior mandible for creation of space for prosthetic components. The remaining 4 implants with unfavorable angulations posed a prosthodontic challenge for fabrication of a prosthesis. The situation was eventually managed by fabrication of a screw-retained metal-resin fixed prosthesis over the remaining 4 implants. Although the situation was managed successfully, it resulted in increased time and treatment expenses, additional appointments, and elaborative steps for correction. Prosthodontics-driven treatment planning concepts and guidelines for prevention of such situations are described in this article. Published by Elsevier Inc.

  4. Medical implants and methods of making medical implants

    DOEpatents

    Shaw, Wendy J; Yonker, Clement R; Fulton, John L; Tarasevich, Barbara J; McClain, James B; Taylor, Doug

    2014-09-16

    A medical implant device having a substrate with an oxidized surface and a silane derivative coating covalently bonded to the oxidized surface. A bioactive agent is covalently bonded to the silane derivative coating. An implantable stent device including a stent core having an oxidized surface with a layer of silane derivative covalently bonded thereto. A spacer layer comprising polyethylene glycol (PEG) is covalently bonded to the layer of silane derivative and a protein is covalently bonded to the PEG. A method of making a medical implant device including providing a substrate having a surface, oxidizing the surface and reacting with derivitized silane to form a silane coating covalently bonded to the surface. A bioactive agent is then covalently bonded to the silane coating. In particular instances, an additional coating of bio-absorbable polymer and/or pharmaceutical agent is deposited over the bioactive agent.

  5. Cochlear implantation updates: the Dallas Cochlear Implant Program.

    PubMed

    Tobey, Emily A; Britt, Lana; Geers, Ann; Loizou, Philip; Loy, Betty; Roland, Peter; Warner-Czyz, Andrea; Wright, Charles G

    2012-06-01

    This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between the University of Texas at Dallas, the University of Texas Southwestern Medical Center, and Children's Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies, and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants. American Academy of Audiology.

  6. Cochlear Implantation Updates: The Dallas Cochlear Implant Program

    PubMed Central

    Tobey, Emily A.; Britt, Lana; Geers, Ann; Loizou, Philip; Loy, Betty; Roland, Peter; Warner-Czyz, Andrea; Wright, Charles G.

    2013-01-01

    This report provides an overview of many research projects conducted by the Dallas Cochlear Implant Program, a joint enterprise between The University of Texas at Dallas, The University of Texas Southwestern Medical Center and Children’s Medical Center. The studies extend our knowledge of factors influencing communication outcomes in users of cochlear implants. Multiple designs and statistical techniques are used in the studies described including both cross sectional and longitudinal analyses. Sample sizes vary across the studies and many of the samples represent large populations of children from North America. Multiple statistical techniques are used by the team to analyze outcomes. The team has provided critical information regarding electrode placement, signal processing, and communication outcomes in users of cochlear implants. PMID:22668764

  7. Biocompatibility of Advanced Manufactured Titanium Implants-A Review.

    PubMed

    Sidambe, Alfred T

    2014-12-19

    Titanium (Ti) and its alloys may be processed via advanced powder manufacturing routes such as additive layer manufacturing (or 3D printing) or metal injection moulding. This field is receiving increased attention from various manufacturing sectors including the medical devices sector. It is possible that advanced manufacturing techniques could replace the machining or casting of metal alloys in the manufacture of devices because of associated advantages that include design flexibility, reduced processing costs, reduced waste, and the opportunity to more easily manufacture complex or custom-shaped implants. The emerging advanced manufacturing approaches of metal injection moulding and additive layer manufacturing are receiving particular attention from the implant fabrication industry because they could overcome some of the difficulties associated with traditional implant fabrication techniques such as titanium casting. Using advanced manufacturing, it is also possible to produce more complex porous structures with improved mechanical performance, potentially matching the modulus of elasticity of local bone. While the economic and engineering potential of advanced manufacturing for the manufacture of musculo-skeletal implants is therefore clear, the impact on the biocompatibility of the materials has been less investigated. In this review, the capabilities of advanced powder manufacturing routes in producing components that are suitable for biomedical implant applications are assessed with emphasis placed on surface finishes and porous structures. Given that biocompatibility and host bone response are critical determinants of clinical performance, published studies of in vitro and in vivo research have been considered carefully. The review concludes with a future outlook on advanced Ti production for biomedical implants using powder metallurgy.

  8. Periodontitis and dental implant loss.

    PubMed

    Lee, Dong Won

    2014-06-01

    Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Review of Effect, Science Direct, and SCOPUS databases were searched. A manual search was performed of issues of the last 15 years of the Journal of Periodontology, International Journal of Periodontics and Restorative Dentistry, Journal of Clinical Periodontology, Journal of Dental Research, Journal of Periodontal Research, Journal of Dentistry, Clinical Oral Investigations, Clinical Oral Implant Research and Clinical Implant Dentistry and Related Research. Prospective cohort studies that compared patients with periodontal disease (PD) to periodontally healthy patients and that reported data on implant loss, peri-implant bone changes or incidence of peri-implantitis were included. Case series, reviews, case reports and retrospective studies were not included. Study selection and risk of bias assessment using the Newcastle-Ottawa Scale was undertaken independently by two reviewers. Dichotomous data were expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Continuous data were expressed as standardised mean differences (SMDs) and random-effects meta-analysis conducted. Fourteen studies were included with sample sizes ranging from 10-717. Meta-analysis (11 studies) showed a higher and significant risk for implant loss in patients affected by PD (RR: 1.89, 95% CI: 1.35-2.66, P = 0.0002) with no evidence of heterogeneity (v2 = 4.31, P = 0.93; I2 = 0%). Significant implant bone loss was present in patients with PD compared with periodontally healthy patients (SMD: 0.44, 95% CI: 0.19-0.69, P = 0.0006) (three studies), with no evidence of heterogeneity (v2 = 2.463, P = 0.27; I2 = 24%). Periodontally compromised patients also showed an increased risk of peri-implantitis compared with patients without PD (RR: 2.21, 95% CI: 1.42-3.43, P = 0.0004), with moderate but not significant heterogeneity (v2 = 7.35, P = 0.12; I2 = 46

  9. Nasal dorsal augmentation with silicone implants.

    PubMed

    Erlich, Mark A; Parhiscar, Afshin

    2003-11-01

    Silicone rubber has been used safely and effectively for facial augmentation for nearly 5 decades in eastern Asia. We have used silicone rubber nasal implants in primary ethnic rhinoplasty and have found consistent and long-lasting results with low complication rates. Silicone dorsal nasal augmentation in primary rhinoplasty avoids donor site morbidity and implant resorption as seen with autogenous implants. Silicone nasal implants have a low extrusion and infection rate. In the appropriate patient with proper placement, silicone nasal implant is nearly the ideal implant material.

  10. Cochlear Implantation in Older Adults

    PubMed Central

    Lin, Frank R.; Chien, Wade W.; Li, Lingsheng; Niparko, John K.; Francis, Howard W.

    2012-01-01

    Cochlear implants allow individuals with severe-to-profound hearing loss access to sound and spoken language. The number of older adults in the United States who are potential candidates for cochlear implantation is approximately 150,000 and will continue to increase with the aging of the population. Should cochlear implantation (CI) be routinely recommended for these older adults, and do these individuals benefit from CI? We reviewed our 12 year experience with cochlear implantation in adults ≥60 years (n = 445) at Johns Hopkins to investigate the impact of CI on speech understanding and to identify factors associated with speech performance. Complete data on speech outcomes at baseline and 1 year post-CI were available for 83 individuals. Our results demonstrate that cochlear implantation in adults ≥60 years consistently improved speech understanding scores with a mean increase of 60. 0% (S. D. 24. 1) on HINT sentences in quiet . The magnitude of the gain in speech scores was negatively associated with age at implantation such that for every increasing year of age at CI the gain in speech scores was 1. 3 percentage points less (95% CI: 0. 6 – 1. 9) after adjusting for age at hearing loss onset. Conversely, individuals with higher pre-CI speech scores (HINT scores between 40–60%) had significantly greater post-CI speech scores by a mean of 10. 0 percentage points (95% CI: 0. 4 – 19. 6) than those with lower pre-CI speech scores (HINT <40%) after adjusting for age at CI and age at hearing loss onset. These results suggest that older adult CI candidates who are younger at implantation and with higher preoperative speech scores obtain the highest speech understanding scores after cochlear implantation with possible implications for current Medicare policy. Finally, we provide an extended discussion of the epidemiology and impact of hearing loss in older adults. Future research of CI in older adults should expand beyond simple speech outcomes to take into

  11. Feasibility of an implanted microphone for cochlear implant listening.

    PubMed

    Gérard, Jean-Marc; Demanez, Laurent; Salmon, Caroline; Vanpoucke, Filiep; Walraevens, Joris; Plasmans, Anke; De Siati, Daniele; Lefèbvre, Philippe

    2017-03-01

    This study aimed at evaluating the feasibility of an implanted microphone for cochlear implants (CI) by comparison of hearing outcomes, sound quality and patient satisfaction of a subcutaneous microphone to a standard external microphone of a behind-the-ear sound processor. In this prospective feasibility study with a within-subject repeated measures design comparing the microphone modalities, ten experienced adult unilateral CI users received an implantable contralateral subcutaneous microphone attached to a percutaneous plug. The signal was pre-processed and fed into their CI sound processor. Subjects compared listening modes at home for a period of up to 4 months. At the end of the study the microphone was explanted. Aided audiometric thresholds, speech understanding in quiet, and sound quality questionnaires were assessed. On average thresholds (250, 500, 750, 1k, 2k, 3k, 4k and 6 kHz) with the subcutaneous microphone were 44.9 dB, compared to 36.4 dB for the external mode. Speech understanding on sentences in quiet was high, within approximately 90% of performance levels compared to hearing with an external microphone. Body sounds were audible but not annoying to almost all subjects. This feasibility study with a research device shows significantly better results than previous studies with implanted microphones. This is attributed to technology enhancements and careful fitting. Listening effort was somewhat increased with an implanted microphone. Under good sound conditions, speech performance is nearly similar to that of external microphones demonstrating that an implanted microphone is feasible in a range of normal listening conditions.

  12. SURFACE CHEMISTRY INFLUENCE IMPLANT BIOCOMPATIBILITY

    PubMed Central

    Thevenot, Paul; Hu, Wenjing; Tang, Liping

    2011-01-01

    Implantable medical devices are increasingly important in the practice of modern medicine. Unfortunately, almost all medical devices suffer to a different extent from adverse reactions, including inflammation, fibrosis, thrombosis and infection. To improve the safety and function of many types of medical implants, a major need exists for development of materials that evoked desired tissue responses. Because implant-associated protein adsorption and conformational changes thereafter have been shown to promote immune reactions, rigorous research efforts have been emphasized on the engineering of surface property (physical and chemical characteristics) to reduce protein adsorption and cell interactions and subsequently improve implant biocompatibility. This brief review is aimed to summarize the past efforts and our recent knowledge about the influence of surface functionality on protein:cell:biomaterial interactions. It is our belief that detailed understandings of bioactivity of surface functionality provide an easy, economic, and specific approach for the future rational design of implantable medical devices with desired tissue reactivity and, hopefully, wound healing capability. PMID:18393890

  13. Implantable drug-delivery systems.

    PubMed

    Blackshear, P J

    1979-12-01

    Implantable drug-delivery systems are being developed to release drugs to the bloodstream continuously as well as free patients from being hospitalized to receive intravenous infusions or frequent injections. One technique is implantation of a pellet in the subcutaneous tissue so the pellet may be released by erosion. Drugs are also diffused through silicone rubber capsules but only polyacrylamide is able to release large molecules. Contraceptive rings containing progesterone and placed in the uterus or vagina and implanted silicone-rubber capsules use these principles. Disadvantages to the subcutaneous delivery of drugs include: 1) release of the drug in subcutaneous tissue rather than in the bloodstream directly; 2) entry into the circulatory system is controlled by surrounding blood supplies which vary with fat; 3) diffusion may be difficult due to dense layers of fibrous tissue; and 4) drug amounts cannot be readily regulated. The Ommaya reservoir uses a container with a self-sealing membrane implanted in the scalp and connected to a cerebral ventricle to treat forms of leukemia and fungal meningitis. Another development is an implantable disk-shaped infusion pump with 2 compartments, the outer one containing a propellant and the inner chamber containing the drug, holds 45 milliliters and releases about 1 milliliter/day. In the future these systems may release drugs in response to biochemical feedback or deliver a drug to 1 specific area.

  14. Capacitive Feedthroughs for Medical Implants

    PubMed Central

    Grob, Sven; Tass, Peter A.; Hauptmann, Christian

    2016-01-01

    Important technological advances in the last decades paved the road to a great success story for electrically stimulating medical implants, including cochlear implants or implants for deep brain stimulation. However, there are still many challenges in reducing side effects and improving functionality and comfort for the patient. Two of the main challenges are the wish for smaller implants on one hand, and the demand for more stimulation channels on the other hand. But these two aims lead to a conflict of interests. This paper presents a novel design for an electrical feedthrough, the so called capacitive feedthrough, which allows both reducing the size, and increasing the number of included channels. Capacitive feedthroughs combine the functionality of a coupling capacitor and an electrical feedthrough within one and the same structure. The paper also discusses the progress and the challenges of the first produced demonstrators. The concept bears a high potential in improving current feedthrough technology, and could be applied on all kinds of electrical medical implants, even if its implementation might be challenging. PMID:27660602

  15. Oxygen isotopes implanted in the LDEF spacecraft

    NASA Technical Reports Server (NTRS)

    Saxton, J. M.; Lyon, I. C.; Chatzitheodoredis, E.; Gilmour, J. D.; Turner, G.

    1992-01-01

    Depth profiles of O-16 and O-18/O-16 were measured on stainless steel nuts and copper sheet (from a grounding strap) recovered from the leading edge of LDEF (Tray E10). The measurements were obtained by dynamic SIMS (secondary ion mass spectrometry) using a VG Isolab 54 ion microprobe. Plots of O-18/O-16 against time, show large depletions of up to a factor of 2 compared to the O-18/O-16 value at sea level. The O-16 current decreases by 2 orders of magnitude in the interior of the metal, and the corresponding profile of anomalous O-16 is strongly peaked in the outer few tens of nanometers of the surface. This depth scale is a tentative one based on estimated sputtering rates. Plots of O-18/O-16 against 1/O-16 should be linear if two isotopically distinct components, one of variable concentration (orbital component) and one of fixed concentration (normal oxygen), are mixed. Data to be presented at the meeting show departures from linearity which result from variability in the concentration of normal oxygen, but may also arise from the implantation of oxygen with a range of fractionation due to the decaying orbit of the LDEF, sputtering of the surface by atomic oxygen, and the different momenta of the two isotopes due to their equal velocities. The potential for using this method as a means of identifying exposure to low-Earth orbit, de-convoluting the effects of space exposure from terrestrial contamination, and using the implanted anomolous oxygen as a means of studying the atomic oxygen density and upper atmosphere temperature height profile will be discussed at the meeting.

  16. Augmentation of peri-implant bone improves implant stability: quantification using simulated bone loss.

    PubMed

    Wirth, Andreas J; Müller, Ralph; van Lenthe, G Harry

    2012-02-01

    Low bone quality, such as induced by osteoporosis, is considered a main factor leading to failure of fracture fixations. Peri-implant bone augmentation has been proposed as a means of reducing failure rates in osteoporotic bone by improving implant stability. The beneficial effects of pharmacological augmentation of bone in the immediate vicinity of the implant have been demonstrated. Yet, a quantitative understanding of the role of peri-implant bone in implant stability is lacking. Therefore, the aim of our study was to quantify the effects of bone loss and peri-implant bone augmentation on implant stability using image-based finite element analyses. Using a validated model, we simulated how osteoporotic bone loss would affect implant stability in human humeral heads. We also quantified how augmentation of peri-implant bone can enhance implant stability. Our simulations revealed that a 30% reduction in bone mass led to a 50% decrease in implant stability. We also found that peri-implant bone augmentation increased implant stability and that the efficiency of bone augmentation decreased with increasing peri-implant distance. These findings highlight the strong effect that bone loss has on implant fixation and the potential of peri-implant bone augmentation for improving implant anchorage in low quality bone. Copyright © 2011 Orthopaedic Research Society.

  17. Managing an extreme peri-implantitis.

    PubMed

    Materni, A

    2013-09-01

    Peri-implantitis leads to gradual peri-implant bone loss. Severe and extreme cases lead to complete implant failure and imply lost implants have to be removed. The aim of the present report is to present a case where an extreme peri-implantitis, causing complete peri-implant bone loss, was managed successfully. A patient already rehabilitated with a prosthesis supported by two implants at positions 3.4 and 3.6 presented with severe peri-implantitis affecting both implants. Initial probing depths were 11 and 9 mm respectively. Implant at position 3.4 showed a bone-implant gap ≥3 mm all around it, but was kept firmly in place by the prosthesis, still supported by the other implant. The patient refused to have her prosthesis removed. In an attempt to save it anyway, after debridement, sandblasting and decontamination of both implant surfaces an enzyme-deantigenic collagenic bone substitute was grafted. Controls followed at 1, 3, 5 and 12 months after surgery. Radiographic exams showed radio-opacity at the grafted sites to gradually increase over time. Postoperative probing depth gain, 7 and 6 mm respectively at position 3.4 and 3.6 remained unchanged at all follow-up controls. After 12 months the patient is asymptomatic and the failed implant can be considered restored. The way we managed this extreme peri-implantitis case has allowed to give clinical success even if, to comply to the patient's will, the best clinical, evidence-based treatment, was not performed. The implant that was otherwise lost was successfully recovered. As an hypothesis, a new osseointegration process could have occurred between the implant and the newly formed bone.

  18. Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation.

    PubMed

    Curi, Marcos Martins; Oliveira, Marcelo Ferraz; Molina, Giuliano; Cardoso, Camila Lopes; Oliveira, Loretta De Groot; Branemark, Per-Ingvar; Ribeiro, Karina de Cássia Braga

    2012-07-01

    Few reports have evaluated cumulative survival rates of extraoral rehabilitation and peri-implant soft tissue reaction at long-term follow-up. The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support craniofacial prostheses. A retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2010. Two outcome variables were considered: implant and prosthetic success. The following predictor variables were recorded: gender, age, implant placement location, number and size of implants, irradiation status in the treated field, date of prosthesis delivery, soft tissue response, and date of last follow-up. A statistical model was used to estimate survival rates and associated confidence intervals. We randomly selected 1 implant per patient for analysis. Data were analyzed using the Kaplan-Meier method and log-rank test to compare survival curves. A total of 150 titanium implants were placed in 56 patients. The 2-year overall implant survival rates were 94.1% for auricular implants, 90.9% for nasal implants, 100% for orbital implants, and 100% for complex midfacial implants (P = .585). The implant survival rates were 100% for implants placed in irradiated patients and 94.4% for those placed in nonirradiated patients (P = .324). The 2-year overall prosthesis survival rates were 100% for auricular implants, 90.0% for nasal implants, 92.3% for orbital implants, and 100% for complex midfacial implants (P = .363). The evaluation of the peri-implant soft tissue response showed that 15 patients (26.7%) had a grade 0 soft tissue reaction, 30 (53.5%) had grade 1, 6 (10.7%) had grade 2, and 5 (8.9%) had grade 3. From this study, it was concluded that craniofacial rehabilitation with extraoral implants is a safe, reliable, and predictable method to restore the patient's normal appearance. Copyright © 2012 American Association of Oral

  19. Implant rehabilitation in bruxism patient

    PubMed Central

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-01-01

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported. PMID:24907215

  20. Silicone implants in augmentation rhinoplasty.

    PubMed

    Zeng, Yanjun; Wu, Weihua; Yu, Hongmei; Yang, Jian; Chen, Guangshen

    2002-01-01

    During the past six years, we have treated 406 patients with classical silicon augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation were examined and discussed. We proposed that most complications are related to the depth of the implant and the character of the tissues. In order to improve our operation and prove our hypothesis, we performed subperiosteal augmentation rhinoplasty in 22 cases with satisfactory results. At the same time, we investigated the biomechanical properties of human nasal periosteum and fascia, including tensile strength, stress-strain relationship and stress relaxation characters under uniaxial tension. Although less elastic, the periosteum has more tensile strength than fascia. So, in the view of biomechanics, the periosteum is thicker, tougher, and stiffer than fascia, thus more suitable for covering silicon implants.

  1. Silicone implant in augmentation rhinoplasty.

    PubMed

    Zeng, Yanjun; Wu, Weihua; Yu, Hongmei; Yang, Jian; Chen, Guangshen

    2002-11-01

    During the past 6 years the authors have treated 406 patients with classic silicone augmentation rhinoplasty. The types and incidence of complications after subcutaneous or subfascial implantation are examined and discussed. They propose that most complications are related to the depth of the implant and the character of the tissues. To improve their operation and to prove their hypothesis, they performed subperiosteal augmentation rhinoplasty in 22 patients with satisfactory results. At the same time, they investigated the biomechanical properties of human nasal periosteum and fascia, including tensile strength, the stress-strain relationship, and stress relaxation characteristics under uniaxial tension. Although it has less failure strain, the periosteum has more tensile strength than fascia. So, in the view of biomechanics, the periosteum is thicker, tougher, and stiffer than fascia, and thus more suitable for covering silicone implants.

  2. Implant rehabilitation in bruxism patient.

    PubMed

    Goiato, Marcelo Coelho; Sonego, Mariana Vilela; dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas

    2014-06-06

    A white female patient presented to the university clinic to obtain implant retained prostheses. She had an edentulous maxillary jaw and presented three teeth with poor prognosis (33, 34 and 43). The alveolar bone and the surrounding tissues were healthy. The patient did not report any relevant medical history contraindicating routine dental treatment or implant surgery, but self-reported a dental history of asymptomatic nocturnal bruxism. The treatment plan was set and two Branemark protocols supported by six implants in each arch were installed after a 6-month healing period. A soft occlusal splint was made due to the patient's history of bruxism, and the lack of its use by the patient resulted in an acrylic fracture. The prosthesis was repaired and the importance of using the occlusal splint was restated. In the 4-year follow-up no fractures were reported.

  3. Optimization of acetabular component orientation using DOE

    NASA Astrophysics Data System (ADS)

    Krepelka, Mircea; Toth-Taşcǎu, Mirela

    2012-09-01

    Stress shielding is increasingly recognized as an important cause of acetabular component failure. Several studies have been focused on improving the acetabular component placement to reduce the risk of dislocation, impingement and range of motion but little is known of its influence on implant-bone interface pressures. This study employs experimental design, 3D reconstruction and FE simulation to identify the most significant factors for acetabular component behavior and predict the best configuration of acetabular spatial orientation angles within the constraints of the Lewinnek's safe zone in order to minimize peak contact pressures. Data analysis by response surface method revealed that the magnitude of periacetabular pressures was significantly reduced by the anteversion angle at its lowest value as well as the abduction angle located at the central point value, which corresponded to a 40° abduction and 5° anteversion of cup orientation.

  4. Spectrophotometric and visual evaluation of peri-implant soft tissue color.

    PubMed

    Benic, Goran I; Scherrer, Daniela; Sancho-Puchades, Manuel; Thoma, Daniel S; Hämmerle, Christoph H F

    2017-02-01

    To spectrophotometrically and visually test whether the peri-implant mucosal color differs from the color of the natural gingiva. Forty single implants in the incisor and premolar region of 40 patients were assessed 3-7 years after implant placement. The differences of the color components lightness, chroma along red-green axis, chroma along yellow-blue axis, and the total color difference ΔE between peri-implant mucosa and natural gingiva were measured with a spectrophotometer. The color difference between peri-implant mucosa and natural gingiva was visually evaluated by clinicians and rated as "clinically visible" or "clinically invisible" from speaking distance. The dimensions of peri-implant mucosa and gingiva at the mid-buccal aspect were evaluated by using cone-beam CT. Spearman analysis was performed to detect correlations between different variables. Two-sided t-test, ANOVA, Mann-Whitney, and Kruskal-Wallis tests were applied to detect differences between the groups. The spectrophotometrically assessed color difference ΔE between peri-implant mucosa and natural gingiva amounted to 7.0 ± 3.9. The peri-implant mucosa presented a significant dark, greenish and bluish discoloration in comparison with gingiva at control teeth. Clinical investigation revealed that in 60% of sites the color difference between peri-implant mucosa and natural gingiva was clinically visible from speaking distance. The threshold value ΔE for the extraoral clinical distinction of mucosal color differences measured 7.5. When comparing the groups with visible and invisible color differences with respect to the three color components, a significant difference was found only for chroma along yellow-blue axis. In the group with visible color difference, mucosa presented a bluish discoloration. Correlation analysis indicated that with an increase in mucosal thickness, a trend for smaller ΔE was found. The spectrophotometrically assessed color of the peri-implant mucosa revealed more

  5. Carbon Fiber Biocompatibility for Implants

    PubMed Central

    Petersen, Richard

    2016-01-01

    Carbon fibers have multiple potential advantages in developing high-strength biomaterials with a density close to bone for better stress transfer and electrical properties that enhance tissue formation. As a breakthrough example in biomaterials, a 1.5 mm diameter bisphenol-epoxy/carbon-fiber-reinforced composite rod was compared for two weeks in a rat tibia model with a similar 1.5 mm diameter titanium-6-4 alloy screw manufactured to retain bone implants. Results showed that carbon-fiber-reinforced composite stimulated osseointegration inside the tibia bone marrow measured as percent bone area (PBA) to a great extent when compared to the titanium-6-4 alloy at statistically significant levels. PBA increased significantly with the carbon-fiber composite over the titanium-6-4 alloy for distances from the implant surfaces of 0.1 mm at 77.7% vs. 19.3% (p < 10−8) and 0.8 mm at 41.6% vs. 19.5% (p < 10−4), respectively. The review focuses on carbon fiber properties that increased PBA for enhanced implant osseointegration. Carbon fibers acting as polymer coated electrically conducting micro-biocircuits appear to provide a biocompatible semi-antioxidant property to remove damaging electron free radicals from the surrounding implant surface. Further, carbon fibers by removing excess electrons produced from the cellular mitochondrial electron transport chain during periods of hypoxia perhaps stimulate bone cell recruitment by free-radical chemotactic influences. In addition, well-studied bioorganic cell actin carbon fiber growth would appear to interface in close contact with the carbon-fiber-reinforced composite implant. Resulting subsequent actin carbon fiber/implant carbon fiber contacts then could help in discharging the electron biological overloads through electrochemical gradients to lower negative charges and lower concentration. PMID:26966555

  6. Carbon Fiber Biocompatibility for Implants.

    PubMed

    Petersen, Richard

    Carbon fibers have multiple potential advantages in developing high-strength biomaterials with a density close to bone for better stress transfer and electrical properties that enhance tissue formation. As a breakthrough example in biomaterials, a 1.5 mm diameter bisphenol-epoxy/carbon-fiber-reinforced composite rod was compared for two weeks in a rat tibia model with a similar 1.5 mm diameter titanium-6-4 alloy screw manufactured to retain bone implants. Results showed that carbon-fiber-reinforced composite stimulated osseointegration inside the tibia bone marrow measured as percent bone area (PBA) to a great extent when compared to the titanium-6-4 alloy at statistically significant levels. PBA increased significantly with the carbon-fiber composite over the titanium-6-4 alloy for distances from the implant surfaces of 0.1 mm at 77.7% vs. 19.3% (p < 10(-8)) and 0.8 mm at 41.6% vs. 19.5% (p < 10(-4)), respectively. The review focuses on carbon fiber properties that increased PBA for enhanced implant osseointegration. Carbon fibers acting as polymer coated electrically conducting micro-biocircuits appear to provide a biocompatible semi-antioxidant property to remove damaging electron free radicals from the surrounding implant surface. Further, carbon fibers by removing excess electrons produced from the cellular mitochondrial electron transport chain during periods of hypoxia perhaps stimulate bone cell recruitment by free-radical chemotactic influences. In addition, well-studied bioorganic cell actin carbon fiber growth would appear to interface in close contact with the carbon-fiber-reinforced composite implant. Resulting subsequent actin carbon fiber/implant carbon fiber contacts then could help in discharging the electron biological overloads through electrochemical gradients to lower negative charges and lower concentration.

  7. Acoustic, aerodynamic, and perceptual analyses of the voice of cochlear-implanted children.

    PubMed

    Guerrero Lopez, Harold A; Mondain, Michel; Amy de la Bretèque, Benoit; Serrafero, Patrick; Trottier, Catherine; Barkat-Defradas, Melissa

    2013-07-01

    The purposes of this study were to compare, from an acoustic approach, the voice of cochlear-implanted children and the one of deaf children using conventional hearing aids (HA) to a control group; to characterize, from an aerodynamic approach, the voice of congenital/prelingual profound deaf children wearing cochlear implants for at least 3 years and implanted before 3 years old; and to classify, from a perceptual approach, the voice of implanted children, of fitted children with conventional HA, and of normal hearing (NH) children as "normal or dysphonic voices." We analyzed 78 voices of children aged 5-13 years using EVA 2 workstation: 38 children with NH, 40 deaf children wearing HA and cochlear implants for at least 3 years and being implanted before 3 years old. Acoustic parameters were measured from a sustained vowel /a/ and speech production and aerodynamic parameters from a set of 10 syllables /pa/. Perceptive assessment was performed by a jury of experienced listeners using G component of Hirano's GRBAS (Grade, Rough, Breathy, Asthenic, Strained) scale. Some acoustic parameters differ significantly between NH children and deaf children's groups with HA and cochlear implants, whereas other parameters are similar between control and cochlear-implanted groups. Analysis of aerodynamic parameters indicates that the phonatory physiological behavior of the implanted group is following an evolution within the norm. Finally, results of perceptual analysis reveal that the implanted group's voice samples can be classified in the first two grades (G0=9, G1=11, n=20) according to the G component (overall dysphonia) of the GRBAS scale. Cochlear implants may improve the majority of acoustic parameters of the voice better than HA for deaf children. Glottal and laryngeal efficiencies were significantly increased with the chronological age and the time of wearing an implant. Results suggest that voices of implanted children in our study do not reveal vocal characteristics

  8. Radiographic evaluation of hip implants.

    PubMed

    Chang, Connie Y; Huang, Ambrose J; Palmer, William E

    2015-02-01

    Serial radiographs are the mainstay in the longitudinal assessment of hip implants. The prosthesis, periprosthetic bone, and juxta-articular soft tissues are inspected for fracture, periosteal reaction, stress shielding, calcar resorption, osteolysis, bony remodeling, metallic debris, and heterotopic ossification. Comparison radiographs best confirm implant migration, subsidence, and aseptic loosening. Infection, particle disease, reaction to metal, and mechanical impingement are important causes of postsurgical pain, but in their earliest stages they may be difficult to diagnose using radiographs. This article addresses the role of radiography following hip arthroplasty. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. A reconnectable multiway implantable connector.

    PubMed

    Rushton, D N; Tromans, A M; Donaldson, N de N

    2002-12-01

    A well-tried plug-and-socket connector system designed for connecting multichannel implanted cables was adapted so as to allow disconnection and reconnection during surgery. Five different sealing techniques were tested in vitro, and it was found that only one of them had the required qualities of high leakage path impedance (taken as more than one megaohm for the worst sample) after three months of saline soak, together with demountability under surgical conditions. The system has subsequently been successfully implemented in a patient in whom reconnection was required two years after implantation.

  10. A Percutaneously Implantable Fetal Pacemaker

    PubMed Central

    Zhou, Li; Vest, Adriana N.; Chmait, Ramen H.; Bar-Cohen, Yaniv; Pruetz, Jay; Silka, Michael; Zheng, Kaihui; Peck, Ray; Loeb, Gerald E.

    2015-01-01

    A miniaturized, self-contained pacemaker that could be implanted with a minimally invasive technique would dramatically improve the survival rate for fetuses that develop hydrops fetalis as a result of congenital heart block. We are currently validating a device that we developed to address this bradyarrhythmia. Preclinical studies in a fetal sheep model are underway to demonstrate that the device can be implanted via a minimally invasive approach, can mechanically withstand the harsh bodily environment, can induce effective contractions of the heart muscle with an adequate safety factor, and can successfully operate for the required device lifetime of three months using the previously-developed closed loop transcutaneous recharging system. PMID:25570982

  11. Mutation breeding by ion implantation

    NASA Astrophysics Data System (ADS)

    Yu, Zengliang; Deng, Jianguo; He, Jianjun; Huo, Yuping; Wu, Yuejin; Wang, Xuedong; Lui, Guifu

    1991-07-01

    Ion implantation as a new mutagenic method has been used in the rice breeding program since 1986, and for mutation breeding of other crops later. It has been shown, in principle and in practice, that this method has many outstanding advantages: lower damage rate; higher mutation rate and wider mutational spectrum. Many new lines of rice with higher yield rate; broader disease resistance; shorter growing period but higher quality have been bred from ion beam induced mutants. Some of these lines have been utilized for the intersubspecies hybridization. Several new lines of cotton, wheat and other crops are now in breeding. Some biophysical effects of ion implantation for crop seeds have been studied.

  12. Physiological and molecular determinants of embryo implantation

    PubMed Central

    Zhang, Shuang; Lin, Haiyan; Kong, Shuangbo; Wang, Shumin; Wang, Hongmei; Wang, Haibin; Armant, D. Randall

    2014-01-01

    Embryo implantation involves the intimate interaction between an implantation-competent blastocyst and a receptive uterus, which occurs in a limited time period known as the window of implantation. Emerging evidence shows that defects originating during embryo implantation induce ripple effects with adverse consequences on later gestation events, highlighting the significance of this event for pregnancy success. Although a multitude of cellular events and molecular pathways involved in embryo-uterine crosstalk during implantation have been identified through gene expression studies and genetically engineered mouse models, a comprehensive understanding of the nature of embryo implantation is still missing. This review focuses on recent progress with particular attention to physiological and molecular determinants of blastocyst activation, uterine receptivity, blastocyst attachment and uterine decidualization. A better understanding of underlying mechanisms governing embryo implantation should generate new strategies to rectify implantation failure and improve pregnancy rates in women. PMID:23290997

  13. The epithelial interface with osseointegrated implants.

    PubMed

    Kellett, M; Smith, G A

    1991-01-01

    The development of osseointegration has generated interest in the field of intraoral and maxillofacial implantology. There is well documented evidence of a high level of success in achieving osseointegration, using titanium and alumina-ceramic implant materials. Long term retention of intraoral implants appears in part, to be dependent upon the integrity of the epithelium/implant interface. This paper presents the design features of two commercially available systems Intra-Mobile-Zylinder (IMZ) and Tubingen (Frialit), which represent titanium and alumina-ceramic implants respectively, and reviews current knowledge of the nature of the epithelial junction to implant materials and the bacterial flora associated with successful and failing implants. Implant failure may be caused by a site specific infection with a similar ecosystem and bacterial flora to that found in periodontal disease. Care in patient selection and maintenance of a healthy epithelial junction are essential for the long term function of osseointegrated implants.

  14. Educational Challenges for Children with Cochlear Implants.

    ERIC Educational Resources Information Center

    Chute, Patricia M.; Nevins, Mary Ellen

    2003-01-01

    This article addresses educational challenges for children with severe to profound hearing loss who receive cochlear implants. Despite the implants, these children face acoustic challenges, academic challenges, attention challenges, associative challenges, and adjustment challenges. (Contains references.) (Author/DB)

  15. Scientists Design Heat-Activated Penis Implant

    MedlinePlus

    ... implant, Le used a heat-activated exoskeleton of nitinol, a metal known for its elasticity. A urologist could do a simplified operation to insert the nitinol implant, which would remain flaccid at body temperature ...

  16. Visualization of Medpor implants using surface rendering.

    PubMed

    Wang, Meng; Gui, Lai; Liu, Xiao-Jing

    2011-09-01

    The Medpor surgical implant is one of the easiest implants in clinical practice, especially in craniomaxillofacial surgery. It is often used as a bone substitute material for the repair of skull defects and facial deformities. The Medpor implant has several advantages but its use is limited because it is radiolucent in both direct radiography and conventional computed tomography, causing serious problems with visualization. In this study, a new technique for visualizing Medpor implants was evaluated in 10 patients who had undergone facial reconstruction using the material. Continuous volume scans were made using a 16-channel tomographic scanner and 3D reconstruction software was used to create surface renderings. The threshold values for surface renderings of the implant ranged from -70 HU to -20 HU, with bone as the default. The shape of the implants and the spatial relationship between bone and implant could both be displayed. Surface rendering can allow successful visualization of Medpor implants in the body.

  17. Minimization of cochlear implant artifact in cortical auditory evoked potentials in children.

    PubMed

    Bakhos, D; Roux, S; Robier, A; Bonnet-Brilhault, F; Lescanne, E; Bruneau, N

    2012-11-01

    In congenitally deaf children fit with a cochlear implant, little is known about the maturation of the auditory cortex. Cortical auditory evoked potentials are a useful methodology to study the auditory cortical system of children with cochlear implants. Nevertheless, these recordings are contaminated by a cochlear implant artifact. The objective of this study was to use independent component analysis to minimize the artifact of the cochlear implant to study cortical auditory evoked potentials. Prospective study. A total of 5 children ranging in age from 21 to 49 months who were fitted with a cochlear implant for at least 6 months were included in this study. The stimuli were pure tones (750 Hz, 200 ms duration, 70 dB SPL) presented with an irregular interstimulus interval (1000-2000 ms) via loud speakers. The cortical auditory evoked potentials were recorded from 17 Ag-AgCl electrodes referenced to the nose. The peak latency and amplitude of each deflection culminating at the fronto-central and temporal sites were analyzed. The P100-N250 peak latencies and amplitudes of the cortical auditory evoked potentials recorded from children fitted with cochlear implants. Scalp map potentials distributions were done for each child for the N250 wave. The use of independent component analysis permitted to minimize the cochlear implant artifact for the five children. Cortical auditory evoked potentials were recorded at fronto-central and temporal sites. Scalp map potentials distributions for the N2 wave showed activation of temporal generators contralateral at the CI for the five children. This preliminary electrophysiological study confirms the value and the limits of independent component analysis. It could allow longitudinal studies in cochlear implant users to examine the maturation of auditory cortex. It could also be used to identify objective cortical electrophysiological measures to help the fitting of CIs in children. Copyright © 2012 Elsevier Ireland Ltd. All rights

  18. Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial.

    PubMed

    Kumar, Vinay V; Ebenezer, Supriya; Kämmerer, Peer W; Jacob, P C; Kuriakose, Moni A; Hedne, Naveen; Wagner, Wilfried; Al-Nawas, Bilal

    2016-11-01

    The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant

  19. Implants and Ethnocide: Learning from the Cochlear Implant Controversy

    ERIC Educational Resources Information Center

    Sparrow, Robert

    2010-01-01

    This paper uses the fictional case of the "Babel fish" to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf…

  20. Implantation of hydroxyapatite-titanium corneal implants in rat cornea.

    PubMed

    Fang, Yin Dong; Xiao, Ma; Fei, Huang Yi

    2011-01-01

    To evaluate the biocompatibility of hydroxyapatite-coated titanium (HA/Ti) corneal implants at the molecular levels with histopathology. Eighty Sprague-Dawley rats were divided into 2 equal groups. In the study group, HA/Ti prosthetics were implanted into the right corneal stroma. The control group received a sham incision. Corneas were collected and studied with histopathological examination (HE), immunohistochemical, and other stains, including scanned electron microscopy and reverse transcription-polymerase chain reaction, to evaluate inflammatory reactions, tissue repair, and expression of various biological factors during healing. In the control group, corneal neovascularization occurred 7 days after surgery, and the corneas recovered 28 days after surgery. In the study group, corneal vascularization increased substantially on day 7 and stabilized on day 28. For both groups, reverse transcription-polymerase chain reaction detected expressions of 6 primers at all time points. The amplified sequences were consistent with the designed sequences. The expression of matrix metalloproteinase-2, matrix metalloproteinase-9, bFGF, vascular endothelial growth factor, and type III collagen were delayed in the study group compared with the control group. Histological analyses showed a tight attachment of the corneal tissue to the HA/Ti implant on day 28. The HA/Ti corneal implants can remain stable in corneal tissue for a long time, induce corneal neovascularization, and stimulate inflammatory cells and keratocytes to synthesize or activate matrix metalloproteinases. Artificial cornea made from this material show enhanced stability and biocompatibility in vivo.