Protection against corneal hyperosmolarity with soft-contact-lens wear

Hyperosmotic tear stimulates human corneal nerve endings, activates ocular immune response, and elicits dry-eye symptoms. A soft contact lens (SCL) covers the cornea preventing it from experiencing direct tear evaporation and the resulting blink-periodic salinity increases. For the cornea to experience hyperosmolarity due to tear evaporation, salt must transport across the SCL to the post-lens tear film (PoLTF) bathing the cornea. Consequently, limited salt transport across a SCL potentially protects the ocular surface from hyperosmotic tear. In addition, despite lens-wear discomfort sharing common sensations to dry eye, no correlation is available between measured tear hyperosmolarity and SCL-wear discomfort. Lack of documentation is likely because clinical measurements of tear osmolarity during lens wear do not interrogate the tear osmolarity of the PoLTF that actually overlays the cornea. Rather, tear osmolarity is clinically measured in the tear meniscus. For the first time, we mathematically quantify tear osmolarity in the PoLTF and show that it differs significantly from the clinically measured tear-meniscus osmolarity. We show further that aqueous-deficient dry eye and evaporative dry eye both exacerbate the hyperosmolarity of the PoLTF. Nevertheless, depending on lens salt-transport properties (i.e., diffusivity, partition coefficient, and thickness), a SCL can indeed protect against corneal hyperosmolarity by reducing PoLTF salinity to below that of the ocular surface during no-lens wear. Importantly, PoLTF osmolarity for dry-eye patients can be reduced to that of normal eyes with no-lens wear provided that the lens exhibits a low lens-salt diffusivity. Infrequent blinking increases PoLTF osmolarity consistent with lens-wear discomfort. Judicious design of SCL material salt-transport properties can ameliorate corneal hyperosmolarity. Our results confirm the importance of PoLTF osmolarity during SCL wear and indicate a possible relation between PoLTF osmolarity and contact-lens discomfort.     

Implant wear induces inflammation, but not osteoclastic bone resorption, in RANK(-/-) mice.

Signaling of RANK (receptor activator of nuclear factor kappa B) through its ligand RANKL appears critical in osteolysis associated with aseptic loosening (AL). The purpose of this study was to investigate the role of RANK in a murine osteolysis model developed in RANK knockout (RANK(-/-)) mice. Ultra high molecular weight polyethylene (UHMWPE) debris was introduced into established air pouches on RANK(-/-) mice, followed by implantation of calvaria bone from syngeneic littermates. Wild type C57BL/6 (RANK(+/+)) mice injected with either UHMWPE or saline alone were included in this study. Pouch tissues were collected 14 days after UHMWPE inoculation for molecular and histology analysis. Results showed that UHMWPE stimulation induced strong pouch tissue inflammation in RANK(-/-) mice, as manifested by inflammatory cellular infiltration, pouch tissue proliferation, and increased gene expression of IL-1beta, TNFalpha, and RANKL. However, the UHMWPE-induced inflammation in RANK(-/-) mice was not associated with the osteoclastic bone resorption observed in RANK(+/+) mice. In RANK(+/+) mice subjected to UHMWPE stimulation, a large number of TRAP(+) cells were found on the implanted bone surface, where active osteoclastic bone resorption was observed. No TRAP(+) cells were found in UHMWPE-containing pouch tissues of RANK(-/-) mice. Consistent with the lack of osteoclastic activity shown by TRAP staining, no significant UHMWPE particle-induced bone resorption was found in RANK(-/-) mice. A well preserved bone collagen content (Van Gieson staining) and normal plateau surface contour [microcomputed tomography (microCT)] of implanted bone was observed in RANK(-/-) mice subjected to UHMWPE stimulation. In conclusion, this study provides the evidence that UHMWPE particles induce strong inflammatory responses, but not associated with osteoclastic bone resorption in RANK(-/-) mice. This indicates that RANK signaling is essential for UHMWPE particle-induced osteoclastic bone resorption, but does not participate in UHMWPE particle-induced inflammatory response.     

Particulate endocytosis mediates biological responses of human mesenchymal stem cells to titanium wear debris.

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.     

Longitudinal relationship between incisal tooth wear and periodontal condition

The purpose of the study was to examine the relationship between the longitudinal development of incisal tooth wear and periodontal conditions in 51 persons. Stone casts obtained at the ages of 15 and 27 yr were used to assess incisal wear according to a graded scale, the Incisal wear Index (Iwl). The wear increase after 12 yr, ΔIwI, was related to the various health index scores at the age of 15 yr, including the Plaque Index (PII) and Gingival Index (GI) systems. The chi-square tests showed a statistically significant association between AIwI and periodontal condition in 15-yr-olds. Thus, relatively low P1I and GI values were accompanied by relatively high AIwI values. It was concluded that in 15-yr-olds, P1I and GI levels are clinical predictors of future wear (ΔIwI) of maxillary and mandibular central incisors. Pocket depth (PD) was a less valuable clinical predictor of such wear.     

聚醚砜耐高温摩阻材料的研究

用热塑性聚(氧-1,4-亚苯基磺酰基-1,4-亚苯基)(聚醚砜)树脂作粘接剂,制备耐高温摩阻材料,探索了材料的压制工艺。试验证实了:聚醚砜树脂和制成的摩阻材料,其耐热性和摩擦磨损性能,较大程度优于改性酚醛树脂和其制成的材料。通过近代表面分析手段对摩擦表面和磨屑进行了分析,并探讨了其磨损机理。     

Polyethylene wear in primary knee arthroplasty

Abstract Polyethylene (PE) wear is a focal issue in joint replacement, so it is essential to understand how it takes place in vivo. PE wear is a multifactorial process with a complex interaction of variables related to the materials used, the mechanical conditions, operative procedures for implantation, activity of the patient and use of prosthesis. We retrieved 65 PE inserts with the respective femoral and tibial components (50 inserts of total knee prostheses and 15 monocompartmental prostheses) from first revision surgeries. The average age of the patients was 68.3 years; the average time to revision was 41.5 months. Macroscopic observation considered the grade, topography and type of wear. Degradation was also studied with scanning electron microscopy. No direct relationship was found between the level of wear and the survival of total or monocompartmental knee prostheses. The duration of 11 (22%) total prosthetic inserts with grade 2 wear was 42.6 months vs. 51.5 months of 17 (34%) total inserts with grade 1 wear. However, study of the relationship between wear grade and wear topography in total inserts suggested that there was a significant connection. In fact, the 22 (44%) prostheses with central and symmetrical wear never showed wear greater than grade 1. Instead, of the remaining 28 prostheses (56%) without central and symmetric wear, only 3 had grade 0 wear. Finally, considering the relationship between wear grade and type of wear, all 18 inserts (27.7%) with grade 2 or 3 wear had 100% delamination. In conclusion, this study suggests that the correct positioning of the prosthetic components, besides its quality, is an important cause of polyethylene wear.     

Morphology of corneal nerves in soft contact lens wear. A comparative study using confocal microscopy

The aim of this study was to evaluate corneal innervation in soft contact lens wearers using the Tomey Confoscan confocal microscope (40x/0.75 objective lens). Three distinct age- and sex-matched subject groups were involved, including extended soft (hydrogel and silicone-hydrogel) contact lens wearers, overnight soft (hydrogel) contact lens wearers, and non contact lens wearers. A number of variables were objectively measured, subjectively evaluated, or graded in order to investigate the distribution and morphology of corneal nerves. For most of the evaluated parameters, no statistically significant differences were found. However, qualitative observations showed noticeable differences in corneal nerve appearance among the different subject groups; the degree of corneal oedema was suggested as the main causative factor. In conclusion, neither the short-term (overnight wear) nor the long-term (12-month extended wear) soft contact lens wear appeared to affect the morphology and/or distribution of corneal nerves as viewed with confocal microscopy.     

In Vitro Wear of Nano-Composite Denture Teeth

PURPOSE: Few laboratory tests have been able to substantiate and quantify the wear resistances of polymeric denture teeth. This study evaluated the relative wear resistance of several types of denture teeth using an in vitro wear testing device. MATERIAL AND METHODS: Four different types of denture teeth [nano-filled (Veracia) and micro-filled composites (SR-Orthosit, Endura, Duradent, Surpass), cross-linked acrylic (SR-Postaris, Genios-P, Creapearl, Vitapan Physiodens, Premium 8, Integral), and a conventional acrylic (Biotone)] were used. The flattened buccal surface of each denture tooth was subjected to the evaluation of Knoop hardness (n=5) and localized wear for 100,000 cycles (n=10). Wear values were determined in micrometers using a profilometer. The data for the hardness, wear depth, and worn surface areas were individually analyzed by one-way ANOVA. RESULTS: Knoop hardness values (KHN) ranged from 28.2 to 29.8 for micro-filled composite, 18.9 to 21.6 for cross-linked acrylic, 22.7 for nano-composite, and 18.6 for conventional acrylic teeth. All micro-filled composite teeth were significantly harder than other teeth (p <0.0001). The wear depth values were 90.5 microm for the nano-composite, 69.8 to 93.0 microm for the micro-filled composite, 80.8 to 104.0 microm for the cross-linked acrylic, and 162.5 microm for conventional acrylic teeth. The worn surface areas were 5.1 mm2 for the nano-composite, 2.6 to 3.6 mm2 for the micro-filled composite, 4.4 to 5.7 mm2 for the cross-linked acrylic, and 10.1 mm2 for conventional acrylic teeth. The wear values of the acrylic control were significantly different from all other denture teeth (p <0.001). CONCLUSION: The nano-composite tooth was harder and more wear resistant than the acrylic teeth but not significantly different from most of the cross-linked and micro-filled composite teeth tested.     

口腔修复陶瓷材料的磨损性能北大核心

背景:陶瓷材料因具有优良的机械性能、与口腔组织良好的生物相容性及高度美观性广泛应用于口腔修复领域,良好的磨损性能对修复体临床应用有重要意义。目的:综述口腔修复陶瓷材料磨损性能机制及临床研究,以期为临床选择适宜的陶瓷材料提供思路。方法:应用计算机在PubMed和Web of Science数据库检索在2016年1月至2021年4月期间涉及口腔修复陶瓷材料磨损性能的相关研究。英文检索词为“dental ceramic material,wear property”,最终共纳入36篇文献进行分析。结果与结论:①全瓷材料自身耐磨性均高于树脂陶瓷复合材料,全瓷材料中氧化锆陶瓷磨损性能最佳,美学性能较弱。②玻璃陶瓷中氧化锆加强型硅酸锂玻璃陶瓷磨损性能较好,但应用时间较短,长期疗效还有待更多的研究证实。③树脂陶瓷复合材料中树脂纳米陶瓷材料磨损性能优于聚合物渗透陶瓷。④在后牙区全冠修复可选择氧化锆陶瓷,前牙区全冠修复可以根据患者的美学需求选择高透性氧化锆陶瓷或玻璃陶瓷。⑤贴面、嵌体和高嵌体修复可选择长石瓷、玻璃陶瓷和树脂陶瓷复合材料,但树脂陶瓷复合材料耐磨性差,需避免用于高应力承载区。⑥对牙本质暴露、氟斑牙和牙齿酸蚀症患者可考虑树脂纳米陶瓷材料,但这类患者适宜的陶瓷材料相关研究较少。⑦表面粗糙度对陶瓷材料的磨损性能有显著影响,临床口腔修复应用中采用良好的抛光表面可提高陶瓷材料磨损性能,而且对修复体进行定期复查也至关重要。