Prostheses and Implants

假体和植入物
  • 文章类型: Case Reports
    波士顿I型人工角膜(KPro-I)已被证明在严重眼烧伤后可成功恢复视力;但是,很少报道其在Phthical眼中的长期结果。一名患有严重碱性化学损伤史的单眼女性,需要在复杂的过程后进行面部移植,左眼具有光线感知,包括失败的KPro-I,治疗性穿透性角膜移植术,眼内炎,矮个子,视网膜完全脱离,和结构变化,包括收缩的18毫米轴向长度和眼壁增厚。患者接受了硅油和KPro-I植入的联合玻璃体切除术,导致她在3年随访时恢复了动态视力(20/250)。
    The Boston Keratoprosthesis type I (KPro-I) has been shown to be successful in restoring vision after severe ocular burns; however, its long-term outcomes in phthisical eyes have rarely been reported. A monocular woman with a history of severe alkali chemical injury necessitating facial transplantation presented with a light perception left eye after a complicated course, including failed KPro-I, therapeutic penetrating keratoplasty, endophthalmitis, hypotony, total retinal detachment, and structural changes, including a shrunken 18 mm axial length and eye wall thickening. The patient underwent a combined vitrectomy with silicone oil and KPro-I implantation, resulting in her regaining ambulatory visual acuity (20/250) at 3 years\' follow-up.
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  • 文章类型: Journal Article
    鉴于骨骼和骨骼界面的分层性质,骨整合,即直接骨-植入物接触的形成,最好使用多尺度方法进行评估。然而,视场和空间分辨率之间存在权衡,使其具有挑战性的图像大体积与高分辨率。在这项研究中,我们将已建立的电子显微镜技术与等离子体聚焦离子束扫描电子显微镜(PFIB-SEM)断层扫描相结合,以在微观和纳米尺度上探测骨-植入物界面,以评估中尺度的骨整合。这种表征工作流程证明了对增材制造的Ti-6Al-4V植入物的骨骼反应,该植入物结合了工程孔隙度以促进骨骼向内生长和通过金雀异黄素的表面功能化,植物雌激素,以抵消骨质疏松症的骨质流失。SEM显示了植入部位的新骨形成,包括在植入物的内部孔隙中。在纳米级,扫描透射电子显微镜和能量色散X射线光谱证实了骨-植入物界面的渐变性质。通过利用PFIB-SEM断层扫描的中尺度分析,以近纳米级分辨率捕获大量的骨-植入物界面,揭示了大小和方向不同的矿物椭圆体的存在。此外,突出显示了发育良好的腔小管网络和朝向植入物和远离植入物的矿化前沿。
    Given the hierarchical nature of bone and bone interfaces, osseointegration, namely the formation of a direct bone-implant contact, is best evaluated using a multiscale approach. However, a trade-off exists between field of view and spatial resolution, making it challenging to image large volumes with high resolution. In this study, we combine established electron microscopy techniques to probe bone-implant interfaces at the microscale and nanoscale with plasma focused ion beam-scanning electron microscopy (PFIB-SEM) tomography to evaluate osseointegration at the mesoscale. This characterization workflow is demonstrated for bone response to an additively manufactured Ti-6Al-4V implant which combines engineered porosity to facilitate bone ingrowth and surface functionalization via genistein, a phytoestrogen, to counteract bone loss in osteoporosis. SEM demonstrated new bone formation at the implant site, including in the internal implant pores. At the nanoscale, scanning transmission electron microscopy and energy-dispersive X-ray spectroscopy confirmed the gradual nature of the bone-implant interface. By leveraging mesoscale analysis with PFIB-SEM tomography that captures large volumes of bone-implant interface with nearly nanoscale resolution, the presence of mineral ellipsoids varying in size and orientation was revealed. In addition, a well-developed lacuno-canalicular network and mineralization fronts directed both towards the implant and away from it were highlighted.
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  • 文章类型: Journal Article
    植入物广泛用于骨科和牙科科学领域。钛(TI)及其合金已成为应用最广泛的植入材料,但植入物相关感染仍然是植入物手术后常见且严重的并发症.此外,钛表现出生物惰性,防止植入物和骨组织强烈结合,并可能导致植入物松动和脱落。因此,预防植入物感染和提高其骨诱导能力是重要目标。
    研究纳米银/聚乳酸乙醇酸(NSPTICU)涂层钛铜合金植入物的抗菌活性和骨诱导能力,为抑制植入物相关感染和促进骨整合提供新的途径。
    我们首先通过研究MC3T3-E1细胞的增殖和分化来检查NSPTICU植入物的体外成骨能力。此外,通过显微计算机断层扫描(micro-CT)研究了NSPTICU植入物诱导SD大鼠成骨活性的能力,苏木精-伊红(HE)染色,masson染色,免疫组织化学和范吉森(VG)染色。用革兰氏阳性金黄色葡萄球菌(Sa)和革兰氏阴性大肠杆菌(E。大肠杆菌)细菌。Sa被用作试验细菌,通过粗视标本采集研究了NSPTICU植入大鼠体内的抗菌能力,细菌菌落计数,HE染色和Giemsa染色。
    茜素红染色,碱性磷酸酶(ALP)染色,实时定量聚合酶链反应(qRT-PCR)和蛋白质印迹分析显示,NSPTICU促进MC3T3-E1细胞的成骨分化。体外抗菌结果表明,NSPTICU植入物表现出更好的抗菌性能。动物实验表明,NSPTICU可抑制炎症反应,促进骨缺损的修复。
    NSPTICU具有出色的抗菌和骨诱导能力,骨缺损的治疗具有广阔的应用前景。
    UNASSIGNED: Implants are widely used in the field of orthopedics and dental sciences. Titanium (TI) and its alloys have become the most widely used implant materials, but implant-associated infection remains a common and serious complication after implant surgery. In addition, titanium exhibits biological inertness, which prevents implants and bone tissue from binding strongly and may cause implants to loosen and fall out. Therefore, preventing implant infection and improving their bone induction ability are important goals.
    UNASSIGNED: To study the antibacterial activity and bone induction ability of titanium-copper alloy implants coated with nanosilver/poly (lactic-co-glycolic acid) (NSPTICU) and provide a new approach for inhibiting implant-associated infection and promoting bone integration.
    UNASSIGNED: We first examined the in vitro osteogenic ability of NSPTICU implants by studying the proliferation and differentiation of MC3T3-E1 cells. Furthermore, the ability of NSPTICU implants to induce osteogenic activity in SD rats was studied by micro-computed tomography (micro-CT), hematoxylin-eosin (HE) staining, masson staining, immunohistochemistry and van gieson (VG) staining. The antibacterial activity of NSPTICU in vitro was studied with gram-positive Staphylococcus aureus (Sa) and gram-negative Escherichia coli (E. coli) bacteria. Sa was used as the test bacterium, and the antibacterial ability of NSPTICU implanted in rats was studied by gross view specimen collection, bacterial colony counting, HE staining and Giemsa staining.
    UNASSIGNED: Alizarin red staining, alkaline phosphatase (ALP) staining, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot analysis showed that NSPTICU promoted the osteogenic differentiation of MC3T3-E1 cells. The in vitro antimicrobial results showed that the NSPTICU implants exhibited better antibacterial properties. Animal experiments showed that NSPTICU can inhibit inflammation and promote the repair of bone defects.
    UNASSIGNED: NSPTICU has excellent antibacterial and bone induction ability, and has broad application prospects in the treatment of bone defects related to orthopedics and dental sciences.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    生殖器成形术,牙面畸形的关键技术,对于建立面部和谐至关重要。这种外科手术需要对下巴进行截骨,改变其三维位置以恢复整体面部平衡。现代生殖器成形术,通常单独进行或与隆鼻术结合进行,整容,和正颌手术,使用各种材料来增加下巴,从自体到异体。最近的改进包括多孔接枝材料,例如高密度聚乙烯。尽管需要安全的截骨段,下颌骨周围的软组织自然倾向于恢复其原始解剖位置。在生殖器成形术的学科中,面部美学和面部评价一直是一个突出的重点,有历史证据强调下巴和谐的相关性,balance,和性格感知。定制的植入物为罕见的解剖缺陷提供了单一疗法,通常发病率较低,使它们对于接受许多手术或患有综合症的患者至关重要。虚拟手术计划的进步将继续为小型和复杂的下巴位置问题提供可靠的解决方案。现代外科医生将继续结合历史,解剖学,严格的评估,优秀的执行力,和技术突破,为患者实现最好的结果,提高他们的社会地位。
    Genioplasty, a key technique for dentofacial abnormalities, is essential for establishing facial harmony. This surgical procedure entails an osteotomy of the chin, which alters its three-dimensional location to restore overall face equilibrium. Modern genioplasty, which is frequently performed alone or in combination with rhinoplasty, facelifts, and orthognathic surgery, employs a variety of materials for chin augmentation, ranging from autologous to alloplastic. Recent improvements include porous graft materials such as high-density polyethylene. Despite the need for secure osteotomy segments, soft tissues around the mandible have a natural propensity to return to their original anatomical position. In the discipline of genioplasty, face esthetics and facial evaluation have been a prominent emphasis, with historical evidence emphasizing the relevance of the chin in harmony, balance, and character perception. Customized implants provide a single therapy for rare anatomical defects, generally with lower morbidity, making them critical for patients undergoing many procedures or suffering from syndromic disorders. Virtual surgical planning advances will continue to give dependable solutions for small and complex chin position issues. Modern surgeons will continue to combine history, anatomy, rigorous evaluation, excellent execution, and technological breakthroughs to achieve the best possible outcomes for their patients, raising their social standing.
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  • 文章类型: Journal Article
    许多不同的方法实现男性面部增强。从短期到长期的结果安排,这些方法包括填料,脂肪/组织移植,脂肪/组织转位,和异体植入物。这项研究仅回顾了同种异体移植物,提供了最可预测的硬组织增强。在这项研究中将讨论一系列的异体体,包括下巴,脸颊,下颌角,额叶,和颞叶植入物。最常见和最严重的并发症也将通过预防和治疗算法进行探索。
    Many different methods achieve male facial augmentation. Arranged from shorter- to longer-term results, these methods include filler, fat/tissue grafting, fat/tissue transposition, and alloplastic implants. This study solely reviews allografts, which provide the most predictable hard-tissue augmentation. An array of alloplasts will be discussed in this study including chin, cheek, mandibular angle, frontal, and temporal implants. The most common and severe complications will also be explored with preventative and treatment algorithms.
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  • 文章类型: English Abstract
    The surface morphology of titanium metal is an important factor affecting its hydrophilicity and biocompatibility, and exploring the surface treatment strategy of titanium metal is an important way to improve its biocompatibility . In this study , titanium (TA4) was firstly treated by large particle sand blasting and acid etching (SLA) technology, and then the obtained SLA-TA4 was treated by single surface treatments such as alkali-heat, ultraviolet light and plasma bombardment. According to the experimental results, alkali-heat treatment is the best treatment method to improve and maintain surface hydrophilicity of titanium. Then, the nanowire network morphology of titanium surface and its biological property, formed by further surface treatments on the basis of alkali-heat treatment, were investigated. Through the cell adhesion experiment of mouse embryonic osteoblast cells (MC3T3-E1), the ability of titanium material to support cell adhesion and cell spreading was investigated after different surface treatments. The mechanism of biological activity difference of titanium surface formed by different surface treatments was investigated according to the contact angle, pit depth and roughness of the titanium sheet surface. The results showed that the SLA-TA4 titanium sheet after a treatment of alkali heat for 10 h and ultraviolet irradiation for 1 h has the best biological activity and stability. From the perspective of improving surface bioactivity of medical devices, this study has important reference value for relevant researches on surface treatment of titanium implantable medical devices.
    钛金属的表面形貌是影响其亲水性及生物相容性的重要因素,探究钛金属表面处理策略是提高其生物相容性的重要途径。本文先采用大颗粒喷砂酸蚀技术(SLA)处理钛金属A4(TA4),对得到的SLA-TA4进行碱热、紫外光照及等离子体轰击等单一方式表面处理。根据实验结果得出,碱热处理是提高并保持钛金属SLA-TA4亲水性的最佳单一处理方法。随后,在碱热处理的基础上,继续研究多种表面处理方式形成的钛金属表面纳米线网络结构及其生物性能。通过小鼠胚胎成骨前体细胞MC3T3-E1黏附实验,比较了不同方式表面处理后,钛金属材料支持细胞黏附、细胞铺展的能力,并根据不同表面处理方式形成的材料表面接触角、微坑深度及粗糙度等参数,分析探讨多种表面处理方式造成的生物活性差异的机制。结果表明,经碱热处理10 h及紫外照射1 h处理后的SLA-TA4 表现出最佳的生物活性及稳定性。从提高医疗器械表面生物活性的角度考虑,本文研究结果或对钛金属植入性器械的表面处理相关研究提供有价值的参考。.
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  • 文章类型: Journal Article
    植入式生物电子学在医疗保健领域拥有巨大的潜力,然而,这些系统的性能在很大程度上依赖于人造机器和活组织之间的接口。在本文中,我们讨论系留接口的最新发展,以及那些非系留接口。其中,研究神经活动的系统由于其创新发展和在当代研究中的高度相关性而受到关注,但其他功能类型的接口系统也进行了探索,以提供该领域的全面概述。我们还分析了关键的考虑因素,包括穿孔部位的选择,修复策略,长期保留,和无线通信,以稳定突出挑战和机遇,有效,和生物相容性接口。此外,我们提出了用于可植入系统的生物相容性电和光学接口的原始模型,同时具有生物相容性,稳定性,和方便。最后,我们指出了接口策略的未来方向。
    Implantable bioelectronics hold tremendous potential in the field of healthcare, yet the performance of these systems heavily relies on the interfaces between artificial machines and living tissues. In this paper, we discuss the recent developments of tethered interfaces, as well as those of non-tethered interfaces. Among them, systems that study neural activity receive significant attention due to their innovative developments and high relevance in contemporary research, but other functional types of interface systems are also explored to provide a comprehensive overview of the field. We also analyze the key considerations, including perforation site selection, fixing strategies, long-term retention, and wireless communication, highlighting the challenges and opportunities with stable, effective, and biocompatible interfaces. Furthermore, we propose a primitive model of biocompatible electrical and optical interfaces for implantable systems, which simultaneously possesses biocompatibility, stability, and convenience. Finally, we point out the future directions of interfacing strategies.
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  • 文章类型: Journal Article
    植入物相关骨髓炎仍然是一个主要的骨科问题。由于嗜中性粒细胞聚集到手术部位是预防感染的关键宿主反应,在感染的天然微环境中,这种动态行为的可视化和量化将阐明以前未被识别的机制,这对于理解宿主反应至关重要。我们最近开发了骨髓(LIMB)的纵向活体成像,以在活体小鼠中受污染的经股植入物上可视化宿主细胞和荧光金黄色葡萄球菌。它允许使用双光子激光扫描显微镜直接观察植入物的细菌定植和宿主细胞反应。在这个模型中,中性粒细胞聚集动力学的严格和可重复的定量结果结束,我们开发了一个强大的分割协议,跟踪,以及从可训练的Weka分割和TrackMate改编的中性粒细胞动力学的量化,两个现成的斐济/ImageJ插件。在这项工作中,具有tdTomato表达中性粒细胞的追赶小鼠接受有或没有ECFP/EGFP表达USA300耐甲氧西林金黄色葡萄球菌(MRSA)的经股骨针,以在2-,4-,植入后6小时。开发的半自动中性粒细胞跟踪协议由两个用户独立执行,以量化距离,位移,速度,速度,和靶细胞的方向性。结果显示,所有结果的用户间可靠性都很高(ICC>0.96;p>0.05)。与在活动性感染期间中性粒细胞聚集增加的既定范例一致,结果还表明,在所有测量的时间点,中性粒细胞的速度和速度都增加,并且在感染的与未感染的小鼠中在更晚的时间点(6小时)位移增加(p<0.05)。嗜中性粒细胞和细菌在感染小鼠的迁移过程中也表现出方向性。半自动细胞跟踪协议提供了一种简化的方法,可以在不同的实验设置中稳健地识别和跟踪单个细胞,并消除观察者间的变异性。
    Implant-associated osteomyelitis remains a major orthopaedic problem. As neutrophil swarming to the surgical site is a critical host response to prevent infection, visualization and quantification of this dynamic behavior at the native microenvironment of infection will elucidate previously unrecognized mechanisms central to understanding the host response. We recently developed longitudinal intravital imaging of the bone marrow (LIMB) to visualize host cells and fluorescent S. aureus on a contaminated transfemoral implant in live mice, which allows for direct visualization of bacteria colonization of the implant and host cellular responses using two-photon laser scanning microscopy. To the end of rigorous and reproducible quantitative outcomes of neutrophil swarming kinetics in this model, we developed a protocol for robust segmentation, tracking, and quantifications of neutrophil dynamics adapted from Trainable Weka Segmentation and TrackMate, two readily available Fiji/ImageJ plugins. In this work, Catchup mice with tdTomato expressing neutrophils received a transfemoral pin with or without ECFP/EGFP-expressing USA300 methicillin-resistant Staphylococcus aureus (MRSA) to obtain 30-minute LIMB videos at 2-, 4-, and 6-hours post-implantation. The developed semi-automated neutrophil tracking protocol was executed independently by two users to quantify the distance, displacement, speed, velocity, and directionality of the target cells. The results revealed high inter-user reliability for all outcomes (ICC > 0.96; p > 0.05). Consistent with the established paradigm on increased neutrophil swarming during active infection, the results also demonstrated increased neutrophil speed and velocity at all measured time points, and increased displacement at later time points (6 hours) in infected versus uninfected mice (p < 0.05). Neutrophils and bacteria also exhibit directionality during migration in the infected mice. The semi-automated cell tracking protocol provides a streamlined approach to robustly identify and track individual cells across diverse experimental settings and eliminates inter-observer variability.
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  • 文章类型: Journal Article
    由于局部细菌感染,骨科和牙科植入物的失败仍然是一个重要的问题。先前的研究试图通过改变其质地和粗糙度或用抗生素涂覆它们来改善植入物表面以增强抗菌性能以延长植入物的寿命。然而,这些方法的有效性有限。在这项研究中,我们试图在纳米尺度上仿生地设计钛(Ti)合金表面,受蝉翼纳米结构的启发,使用碱性水热处理(AHT)同时赋予抗菌性能并支持哺乳动物细胞的粘附和增殖。使用4h和8hAHT工艺在1NNaOH中在230°C下开发了两个改性的Ti表面,随后在600°C下进行2小时后煅烧我们发现对照板显示出相对光滑的表面,而处理组(4h和8hAHT)显示出含有随机分布的纳米尖峰的纳米下层结构。结果表明,治疗组的接触角在统计学上显着降低,这增加了润湿性特征。8hAHT组的润湿性最高,粗糙度显着增加0.72±0.08µm(P<0.05),导致更多的成骨细胞附着,降低细胞毒性作用,增强了相对生存能力。在所有不同的组中测量的碱性磷酸酶活性表明8hAHT组表现出最高的活性,表明处理组的表面粗糙度和润湿性可能促进了细胞的粘附和附着,并随后增加了细胞外基质的分泌。总的来说,研究结果表明,由AHT过程产生的仿生纳米纹理表面有可能被转化为植入物涂层,以增强骨再生和植入物整合。
    Orthopedic and dental implant failure continues to be a significant concern due to localized bacterial infections. Previous studies have attempted to improve implant surfaces by modifying their texture and roughness or coating them with antibiotics to enhance antibacterial properties for implant longevity. However, these approaches have demonstrated limited effectiveness. In this study, we attempted to engineer the titanium (Ti) alloy surface biomimetically at the nanometer scale, inspired by the cicada wing nanostructure using alkaline hydrothermal treatment (AHT) to simultaneously confer antibacterial properties and support the adhesion and proliferation of mammalian cells. The two modified Ti surfaces were developed using a 4 h and 8 h AHT process in 1 N NaOH at 230 °C, followed by a 2-hour post-calcination at 600 °C. We found that the control plates showed a relatively smooth surface, while the treatment groups (4 h & 8 h AHT) displayed nanoflower structures containing randomly distributed nano-spikes. The results demonstrated a statistically significant decrease in the contact angle of the treatment groups, which increased wettability characteristics. The 8 h AHT group exhibited the highest wettability and significant increase in roughness 0.72 ± 0.08 µm (P < 0.05), leading to more osteoblast cell attachment, reduced cytotoxicity effects, and enhanced relative survivability. The alkaline phosphatase activity measured in all different groups indicated that the 8 h AHT group exhibited the highest activity, suggesting that the surface roughness and wettability of the treatment groups may have facilitated cell adhesion and attachment and subsequently increased secretion of extracellular matrix. Overall, the findings indicate that biomimetic nanotextured surfaces created by the AHT process have the potential to be translated as implant coatings to enhance bone regeneration and implant integration.
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