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1.
《International journal of oral and maxillofacial surgery》2020,49(7):914-931
Titanium osteosynthesis is currently the fixation system of choice in maxillofacial traumatology. Biodegradable osteosynthesis systems have the ability to degrade in the human body. The aim of this study was to conduct a systematic review, with meta- and trial sequential analyses, to assess the efficacy and morbidity of biodegradable versus titanium osteosynthesis after maxillofacial trauma. MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials and prospective and retrospective controlled studies. Five time periods were studied: perioperative, short-term (0–4 weeks), intermediate (6–12 weeks), long-term (>12 weeks), and overall follow-up. After screening 3542 records, 24 were included. All had a high risk of performance and detection bias due to the nature of the interventions. Meta-analysis showed no differences in efficacy or morbidity between biodegradable and titanium osteosynthesis. The risk of perioperative screw breakage was significantly higher (risk ratio 17.13, 95% confidence interval 2.19–34.18) and the symptomatic plate removal rate lower in the biodegradable group (risk ratio 0.11, 95% confidence interval 0.02–0.57), which was confirmed by the trial sequential analysis. The quality of evidence ranged from very low to moderate. Based on the narrative review and meta-analyses, current evidence shows that biodegradable osteosynthesis is a viable alternative to titanium osteosynthesis when applied in the treatment of maxillofacial trauma, with similar efficacy but significantly lower symptomatic plate removal rates. Perioperative screw breakage occurred significantly more often in the biodegradable group compared to the titanium group. 相似文献
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Chukwuka C Okafor Hana Haleem-Smith Patrice Laqueriere Paul A Manner Rocky S Tuan 《Journal of orthopaedic research》2006,24(3):461-473
Continual loading and articulation cycles undergone by metallic (e.g., titanium) alloy arthroplasty prostheses lead to liberation of a large number of metallic debris particulates, which have long been implicated as a primary cause of periprosthetic osteolysis and postarthroplasty aseptic implant loosening. Long-term stability of total joint replacement prostheses relies on proper integration between implant biomaterial and osseous tissue, and factors that interfere with this integration are likely to cause osteolysis. Because multipotent mesenchymal stem cells (MSCs) located adjacent to the implant have an osteoprogenitor function and are critical contributors to osseous tissue integrity, when their functions or activities are compromised, osteolysis will most likely occur. To date, it is not certain or sufficiently confirmed whether MSCs endocytose titanium particles, and if so, whether particulate endocytosis has any effect on cellular responses to wear debris. This study seeks to clarify the phenomenon of titanium endocytosis by human MSCs (hMSCs), and investigates the influence of endocytosis on their activities. hMSCs incubated with commercially pure titanium particles exhibited internalized particles, as observed by scanning electron microscopy and confocal laser scanning microscopy, with time-dependent reduction in the number of extracellular particles. Particulate endocytosis was associated with reduced rates of cellular proliferation and cell-substrate adhesion, suppressed osteogenic differentiation, and increased rate of apoptosis. These cellular effects of exposure to titanium particles were reduced when endocytosis was inhibited by treatment with cytochalasin D, and no significant effect was seen when hMSCs were treated only with conditioned medium obtained from particulate-treated cells. These findings strongly suggest that the biological responses of hMSCs to wear debris are triggered primarily by the direct endocytosis of titanium particulates, and not mediated by secreted soluble factors. In this manner, therapeutical approaches that suppress particle endocytosis could reduce the bioreactivity of hMSCs to particulates, and enhance long-term orthopedic implant prognosis by minimizing wear-debris periprosthethic osteolysis. 相似文献
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刘斌 《中国神经再生研究》2009,13(34)
利用电化学方法研究医用钛合金在0.9%NaCl生理盐水,模拟人工唾液,模拟人工体液中的腐蚀情况,分析腐蚀电位和腐蚀电流密度,扫面电镜观察腐蚀表面形貌,CA-A型接触角测试仪测试钛合金表面被腐蚀后接触角的变化。实验表明:钛合金在三种生理电解液中的腐蚀情况依次是:模拟人工唾液〉模拟人工体液〉0.9%NaCl生理盐水。扫面电镜观察表明,医用钛合金在0.9% NaCl生理盐水腐蚀后,表面出现了许多腐蚀孔,经模拟人体体液腐蚀后,表面变得粗糙不平整,腐蚀孔数目变化不大,钛合金经人工唾液腐蚀后,腐蚀孔数目增多,部分腐蚀孔孔径明显增大。经三种生理电解液腐蚀后,钛合金表面接触角都减小。结论:医用钛合金在人工唾液中的腐蚀最严重,在临床应用中应给予相应的防范措施。 相似文献
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Angelo Lipira David Limbrick Bruce Haughey Phillip Custer Michael R. Chicoine 《Skull base》2009,19(4):303-309
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Jaafar Mouhyi Lars Sennerby Jeanjacques Pireaux Nicolas Dourov Samir Nammour Jack Van Reck 《Clinical oral implants research》1998,9(3):185-194
The purpose of the present study was to analyse clinically failed and retrieved implants prior to and after cleaning by means of scanning electron microscopy (SEM) and X-ray induced photoelectron spectroscopy (XPS) as compared to unused controls. Six different chemical and physical techniques for cleaning of contaminated titanium implants were evaluated: 1) rinsing in absolute ethanol for 10 min, 2) cleaning in ultrasonic baths containing trichloroethylene (TRI) and absolute ethanol, 10 min in each solution, 3) abrasive cleaning for 30 s, 4) cleaning in supersaturated citric acid for 30 s, 5) cleaning with continuous CO2-laser in dry conditions at 5 W for 10 s, 6) cleaning with continuous CO2-laser in wet conditions (saline) at 5 W for 10 s. SEM of failed implants showed the presence of contaminants of varying sizes and XPS showed almost no titanium but high carbon signals. XPS of unused titanium implants showed lower levels of titanium as previously reported, probably due to contamination of carbon which increased with time in room air. Cleaning of used implants in citric acid followed by rinsing with deionized water for 5 min followed by cleaning in ultrasonic baths with TRI and absolute ethanol gave the best results with regard to macroscopical appearance and surface composition. However, as compared to the unused implants the results from an element composition point of view were still unsatisfactory. It is concluded that further development and testing of techniques for cleaning of organically contaminated titanium is needed. 相似文献
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热力学计算表明,H2,N2的过量有助于提高TiN的产率,但能耗也相应增加。为此考察了温度,流量,TiCl4携带量,混合方式对产物性能的影响。结果表明,流量增加,温度升高,TiCl4携带量增加,混合愈好,则产物粒径愈小。在此基础上采用微波等离子体化学气相沉积法,合成了粒径为123-284nm的TiN超细颗粒 相似文献
9.
钛板联合羟基磷灰石人工骨眼眶重建 总被引:5,自引:0,他引:5
目的:探讨应用钛板联合羟基磷灰石人工骨矫正眼眶骨折眼球内陷的手术方法和疗效。方法:根据术前CT诊断明确的14例14眼眼眶骨折患者,术中用钛钉、钛板将复位的眶缘骨折进行坚强内固定.重建正常的眶缘,然后用羟基磷灰石人工骨材料植入眼眶,以填补眶腔容积的缺损,同时修复重建眶壁。结果:术后随访3~36个月,CT水平和冠状位扫描复查,10例眼球内陷的患者中,8例获得矫正,2例仍存中度内陷;8例复视患者中,7例获得满意改善,1例无效。无植人物感染、移位和脱出,未见视力丧失者。结论:钛板和复合羟基磷灰石人工骨具有很好的生物相容性,在眶壁重建手术中可获得满意的疗效。是眶壁重建术良好的替代材料。 相似文献
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