Objective: To appraise whether adverse events following oral implant placement may be associated with peri-operative use of non-steroidal anti-inflammatory drugs (NSAIDs). Methods: All patients with recorded implant failures between 1979 and 2012 in the Implant Prosthodontics Unit were contacted to solicit additional information about potential peri-operative use of NSAIDs. Results: From a total of 168 patients with 292 implant failures between 1979 and 2012, 122 consented to participate and had intact records. Just over half (56.6%) reported no peri-operative NSAID usage. However, compared to patients who did not use peri-operative NSAIDs, four times as many had complicated medical histories and twice as many patients taking NSAIDs suffered multiple implant failures. Conclusions: Patients with a variety of systemic diseases may be adversely affected by the inhibitory effect of NSAIDs on bone healing. Further prospective clinical studies are warranted to clarify this potential causative relationship in humans.

Objective: To appraise whether adverse events following oral implant placement may be associated with peri-operative use of non-steroidal anti-inflammatory drugs (NSAIDs). Methods: All patients with recorded implant failures between 1979 and 2012 in the Implant Prosthodontics Unit were contacted to solicit additional information about potential peri-operative use of NSAIDs. Results: From a total of 168 patients with 292 implant failures between 1979 and 2012, 122 consented to participate and had intact records. Just over half (56.6%) reported no peri-operative NSAID usage. However, compared to patients who did not use peri-operative NSAIDs, four times as many had complicated medical histories and twice as many patients taking NSAIDs suffered multiple implant failures. Conclusions: Patients with a variety of systemic diseases may be adversely affected by the inhibitory effect of NSAIDs on bone healing. Further prospective clinical studies are warranted to clarify this potential causative relationship in humans.

Tissue engineering is a multidisciplinary field that is rapidly emerging as a promising approach for tissue repair and regeneration. In this approach, scaffolds which allow cells to invade the construct and guide the cells grow into specific tissue play a pivotal role. Electrospinning has gained popularity recently as a simple and versatile method to produce fibrous structures with nano- to microscale dimensions. These electrospun fibers have been extensively applied to create nanofiber scaffolds for tissue engineering applications. Specifically for bone and cartilage tissue engineering, polymeric materials have some attractive properties such as the biodegradability. Ceramic scaffolds and implant coatings, such as hydroxyapatite and silica-based bioglass have also been considered as bone graft substitutes for bone repair because of their bioactivity and, in some cases, tunable resorbability. Besides tissue engineering scaffolds, for clinical application, especially for load-bearing artificial implants, metallic materials such as titanium are the most commonly used material. Osseointegration between bone and implants is very essential for implant success. To achieve better osseointegration between bone and the implant surface, three dimensional porous structures can provide enhanced fixation with bone by allowing tissue to grow into the pores. In this study, pre-3D electrospun polymer and ceramic scaffolds with peptide conjugation and 3D titanium scaffolds with different surface morphology were fabricated to testify the osteoblast and mensechymal stem cell attachment and differentiation. The overall goal of this thesis is to determine if the peptide functionalization of polymeric scaffolds and physical parameters of ceramic and metallic scaffold can promote osteoblast maturation and mesenchymal stem cell differentiation in vitro to achieve an optimal scaffold design for greater osseointegration. The results of the studies showed with functionalization of MSC- specific peptide, polymer scaffolds behaved with higher biocompatibility and MSC affinity. For the ceramic and metallic scaffolds, microstructures and nanostructures can synergistically promote osteoblast maturation and 3D micro-environment with micro-roughness is a promising design for osteoblast maturation and MSC differentiation in vitro compared to 2D surfaces.

The present work addresses poor bone/implant integration and severe bone defects. In both conditions external stimuli is required for new bone to form. A multilayered functional implant coating, comprised of an inner layer of crystalline titanium dioxide (TiO2) and an outer layer of hydroxyapatite (HAP), loaded with bone morphogenetic protein-2 (BMP-2), was proposed as a tool for providing both improved initial bone formation and long-term osseointegration. The in vitro characterization of the implant coatings showed that TiO2 and HAP were more favorable for cell viability, cell morphology and initial cell differentiation, compared to native titanium oxide. Furthermore, significantly higher cell differentiation was observed on surfaces with BMP-2, indicating that a simple soaking process can be used for incorporating bioactive molecules. Moreover, the results suggest that there could be a direct interaction between BMP-2 and HAP, which prolongs the retention of the growth factor, improving its therapeutic effect. For treating severe bone defects a strategy involving BMP-2 delivery from hyaluronan hydrogels was explored. The hydrogels were prepared from two reactive polymers – an aldehyde-modified hyaluronan and a hydrazide-modified poly(vinyl alcohol). Upon mixing, the two components formed a chemically crosslinked hydrogel. In this work the mixing of the hydrogel components was optimized by rheological measurements. Furthermore, an appropriate buffer was selected for in vitro experiments by studying the swelling of hydrogels in PBS and in cell culture medium. A detection method, based on radioactive labeling of BMP-2 with 125I was used to monitor growth factor release both in vitro and in vivo. The results showed a biphasic release profile of BMP-2, where approximately 16 %  and 3 % of the growth factor remained inside the hydrogel after 4 weeks in vitro and in vivo, respectively. The initial fast release phase corresponded to the early ectopic bone formation observed 8 d after injection of the hydrogel formulation in the thigh muscle of rats. The hydrogel formulation could be improved by incorporation of HAP powder into the hydrogel formulation. Furthermore, bone formation could be increased by pre-incubation of the premixed hydrogel components inside the syringe prior to injection. Crushed hydrogels were also observed to induce more bone formation compared to solid hydrogels, when implanted subcutaneously in rats. This was thought to be due to increased surface area of the hydrogel, which allowed for improved cell infiltration.

Η αναθεώρηση μιας ολικής αρθροπλαστικής ισχίου λόγω χαλάρωσης του μηριαίου τμήματος της αποτελεί μια πρόκληση ακόμα και για πεπειραμένους χειρουργούς. Η άσηπτη χαλάρωση συνήθως σχετίζεται με κάποιο βαθμό οστικής απώλειας. Διερευνήσαμε εάν η πρόθεση Zweymüller SLR-Plus ®, μαζί με την βιολογική αναδόμηση με αλλομοσχεύματα του ελλειμματικού οστικού περιβάλλοντος του μηριαίου, θα επιτύγχανε επιβίωση, οστεοενσωμάτωση και σταθερότητα παρόμοια ή και καλύτερη από άλλες προθέσεις που χρησιμοποιούνται στη βιβλιογραφία για αναθεώρηση του μηριαίου τμήματος ΟΑΙ. Εξετάσαμε αναδρομικά 69 επιλεγμένους ασθενείς (70 ισχία) οι οποίοι υποβλήθηκαν σε αναθεώρηση του μηριαίου τμήματος με χρήση του SLR-Plus ® στειλεού σε μια περίοδο 10 ετών. Οι ενδείξεις για την αναθεώρηση περιελάμβαναν άσηπτη και σηπτική αποτυχία της βιολογικής στερέωσης, εσφαλμένη εμφύτευση, και περιπροθετικό κάταγμα. Επτά ασθενείς πέθαναν και τέσσερις χάθηκαν κατά το διάστημα παρακολούθησης. Πενήντα οκτώ από τους 69 ασθενείς (59 ισχία) ήταν διαθέσιμοι σε μέσο χρονικό διάστημα 8,3 ± 2,7 χρόνια (εύρος, 4-14 ετών) μετά τη χειρουργική επέμβαση αναθεώρησης. Υπήρχαν 14 άνδρες και 44 γυναίκες (μέση ηλικία, 69 έτη, εύρος, 42-89 ετών). Τέσσερις μηριαίες προθέσεις (7%) αναθεωρήθηκαν ξανά. Η 10ετής επιβίωση της πρόθεσης λαμβάνοντας ως αιτία αναθεώρησης την άσηπτη χαλάρωση ήταν 95% (95% C.I.: 86% -98%). Δεν παρατηρήθηκε περιπροθετική οστεόλυση του μηριαίου γύρω από την πρόθεση και 91% των SLR-Plus στειλεών εμφανίστηκε ακτινολογικά σταθερό είτε μέσω οστεοενσωμάτωσης είτε μέσω ινώδους στερέωσης. Με βάση τα στοιχεία επιβίωσης, πιστεύουμε ότι η χρήση του SLR-Plus® στειλεόυ είναι μια αξιόπιστη λύση για τους ασθενείς που υποβάλλονται σε χειρουργική επέμβαση αναθεώρησης ΟΑΙ, με απώλεια οστικής μάζας στο κεντρικό τμήμα του μηριαίου. / Revision after failed THA resulting from loosening of the femoral component can be challenging even for experienced surgeons. Aseptic loosening usually is associated with some degree of bone loss. We asked whether the Zweymüller SLR-Plus®, along with allograft reconstruction of the deficient femoral bone stock, would provide survivorship, osseointegration, and stability similar to or better than previously reported implants for femoral revision. We retrospectively reviewed 69 selected patients (70 hips) who underwent revision of the femoral component using the SLR-Plus® stem during a 10-year period. The indications for revision included aseptic and septic failure of biologic fixation, incorrect implantation, and periprosthetic fracture. Seven patients died and four were lost to followup. Fifty-eight of the 69 patients (59 hips) were available at a mean 8.3 ± 2.7 years (range, 4–14 years) after revision surgery. There were 14 men and 44 women (mean age, 69 years; range, 42–89 years). Four stems (7%) were rerevised. With rerevision for aseptic reasons, the survival at 10 years was 95% (95% confidence interval, 86%–98%). No femoral periprosthetic osteolysis occurred around the stem and 91% of stems appeared stable radiographically (osseointegration, fibrous). Based on the survival data, we believe the SLR-Plus® stems are reliable for patients undergoing hip revision surgery with central bone loss.

Made available in DSpace on 2014-06-11T19:33:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-06-15Bitstream added on 2014-06-13T21:05:33Z : No. of bitstreams: 1 faeda_rs_dr_arafo.pdf: 15247078 bytes, checksum: c62d1ae9dfd05690aa2ca25b49d04945 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O sucesso dos sistemas modernos de implantes dentais tem sido relacionado ao desenvolvimento do design e das características de superfícies dos implantes. O propósito do presente estudo foi avaliar duas novas superfícies de implantes (modificada por laser - LMS e recoberta por hidroxiapatita biomimética - HA), comparando-as a outro implante comercial, (superfície usinada – MS). Um total de 144 implantes (3,75 x 10mm), 48 de cada superfície, foram instalados na tíbia de coelhos e avaliados após 4, 8 e 12 semanas. Após os períodos de cicatrização os animais foram sacrificados, um dos implantes expostos e a força necessária para derosquea-los foi aferida por um torquímetro analógico. O outro implante foi removido com o tecido ósseo peri-implantar e processado por corte histológico calcificado para análise histomorfométrica do contato osso-implante (BIC%) e da área óssea entre espiras (BBT%). Em 4 e 8 semanas, os implantes HA apresentaram valor de torque de remoção estatisticamente superior (p<0,05) quando comparado aos demais, sendo o mesmo observado para os implantes LMS quando comparados aos MS. Após 12 semanas, os implantes HA e LMS foram estatisticamente superiores aos implantes MS. Por outro lado, a análise do contato osso-implante mostrou que na região cortical, os implantes LMS e HA foram estatisticamente superiores ao MS para todos os períodos de cicatrização, sem diferença estatística entre LMS e HA. A análise histomorfométrica mostrou que, quando comparados na região endosteal, os implantes LMS e HA foram estatisticamente superiores ao MS no período inicial de cicatrização. Embora os implantes LMS e HA não apresentassem diferenças estatísticas entre eles, uma tendência de maiores valores de BIC% para HA na região endosteal foi observada em todos os períodos do estudo.Os resultados deste estudo mostram que apesar de não haver diferença... / Purpose: Considering the great biological potential of the association between laser ablation and hydroxyapatite thin layer coatings to create an interesting bioactive environment on titanium dental implants, the aim of the present study was to investigate, by histomorphometrical and removal torque analysis, the histological effects of a surface treatment created by laser-ablation (Nd:YAG) and, later, thin deposition of HA particles by a chemical process compared to implants with only laser-ablation and implants with machined surfaces. Materials and Methods: Forty-eight rabbits received two implant by tibiae of the following surfaces: Machined surface (MS), laser-modified surface (LMS) and biomimetic hydroxiapatite coated surface (HA). After 4, 8 and 12 weeks of healing, one implant was exposed, and the needed force to unscrew measured using an analogical torque gauge. The other implant and surrounding bone was removed and prepared by a calcified histological process. The percentage of bone-to-implant contact (BIC) and the bone area formed between the threads (BBT) were evaluated separately to the cortical and endosteal region. Results: The difference was statistically significant (P < .05) between the LMSMS and HA-MS surfaces in all periods of evaluation, and between LMS-HA to 4 and 8 weeks of healing. The surface characterization showed a deep, rough, and regular topography provided by the laser conditioning, that was followed by the HA coating. Average BIC percentage in the cortical region was significantly higher (P<0.001) on the LMS and HA implants, compared with MS ones for all periods of healing, having no statistical differences between LMS and HA. When compared in the endosteal area, the LMS and HA implants showed statistically higher (P<0.01) BIC percentage values than MS at the initial periods of healing (LMS after 4 weeks and HA after 4 and 8 weeks, respectively)... (Complete abstract click electronic access below)

This dissertation thesis deals with the evaluation of biocompatibility and osseointegration of nanostructured titanium materials used for dental implants. Bulk material topography and surface modification of titanium are currently of intense research mainly due to the significant impact on biocompatibility and improvement of osseointegration of dental implants. In the theoretical part are described types of titanium material and different methods of its surface modification. In vitro and in vivo biocompatibility and osseointegration tests are described as well. The experimental work consists of two parts of experiments. In the first experiment, we examined how grain size of nanostructured titanium material influences the behaviour of fibroblastic as well as osteoblastic cells growth on its surface. The experimentally obtained data were statistically analysed and discussed. Grain size was proven to be an important factor that influenced not only the strength of material but also its interactions with cells. The second experiment describes current methods used in the experimental evaluation of osseointegration of dental implants. The results of histological staining methods are illustrated and compared. A standardized and reproducible technique for stereological quantification of bone-implant contact...

Submitted by GABRIEL MULINARI DOS SANTOS (gabriel_mulinari@hotmail.com) on 2018-02-14T10:31:03Z No. of bitstreams: 1 Dissertacao_Gabriel_Repositorio.pdf: 2013798 bytes, checksum: e83e70bf61f06fb298685c59bc39ea6f (MD5) / Approved for entry into archive by Claudio Hideo Matsumoto null (claudio@foa.unesp.br) on 2018-02-14T18:04:12Z (GMT) No. of bitstreams: 1 santos_gm_me_araca_int.pdf: 2013798 bytes, checksum: e83e70bf61f06fb298685c59bc39ea6f (MD5) / Made available in DSpace on 2018-02-14T18:04:12Z (GMT). No. of bitstreams: 1 santos_gm_me_araca_int.pdf: 2013798 bytes, checksum: e83e70bf61f06fb298685c59bc39ea6f (MD5) Previous issue date: 2018-02-09 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: A hipertensão está associada a doenças cardiovasculares, mas também com alterações na qualidade óssea. A hipertensão, portanto, pode ser um fator de risco para a osseointegração. Estudos pré-clínicos sugerem que o losartan, um bloqueador dos receptores da angiotensina II amplamente utilizado para tratar a hipertensão, tem um efeito benéfico na consolidação do enxerto. No entanto, o efeito da hipertensão e do losartan na osteointegração permanece desconhecido. Material e Métodos: Aqui utilizamos ratos ratas espontaneamente hipertensivos (SHR) e ratos Wistar albinus normotensos que receberam losartan (30 mg / kg, p.o.) ou não tratados. Após uma semana, mini-implantes de titânio foram inseridos na tíbia. Sessenta dias após a implantação, a estabilidade do implante foi avaliada pela medição de torque de remoção considerada o ponto final primário. A tomografia computadorizada micro e a análise histomorfométrica foram parâmetros secundários. Resultados: o Losartan aumentou o torque de remoção no grupo SHR hipertenso para os níveis dos controles Wistar. Enquanto os parâmetros corticais da osseointegração permaneceram inalterados, losartan aumentaram a formação do osso medular. A micro tomografia computorizada revelou maior volume ósseo por volume de tecido e espessura trabecular nos ratos SHR tratados com losartan. A análise histomorfométrica mostrou ainda que o losartan aumentou significativamente a espessura do osso recém-formado na área medular em ratos SHR hipertensos. O losartan não alterou significativamente os parâmetros de osseointegração em ratos normotensos. Conclusões: Os dados apresentados sugerem que o antagonista dos receptores da angiotensina II losartan aumenta os parâmetros medulares da osseointegração no modelo da tíbia de ratos espontaneamente hipertensos. / Background: Hypertension is associated with cardiovascular diseases but also with alterations in bone quality. Hypertension therefore might be a risk factor for osseointegration. Preclinical studies suggest that losartan, an angiotensin II receptor blocker widely used to treat hypertension, has a beneficial effect in graft consolidation. However, the effect of hypertension and losartan on osseointegration remains unknown. Methods: Here we used spontaneously hypertensive rats (SHR) and normotensive Wistar albinus rats receiving losartan (30 mg/kg, p.o.) or left untreated. After one week, titanium miniscrews were inserted into the tibia. Sixty days after implantation, implant stability was evaluated by removal torque measurement considered the primary endpoint. Micro computed tomography and histomorphometric analysis were secondary endpoints. Results: Losartan increased the removal torque in the hypertensive SHR group to levels of the Wistar controls. While the cortical parameters of osseointegration remained unchanged, losartan increased medullary bone formation. Micro computed tomography revealed a higher bone volume per tissue volume and trabecular thickness in the SHR rats treated with losartan. Histomorphometric analysis further showed that losartan significantly increased the thickness of newly formed bone in medullary area in hypertensive SHR rats. Losartan did not significantly alter the parameters of osseointegration in normotensive rats. Conclusions: The data presented suggest that the angiotensin II receptor antagonist losartan increases the medullary parameters of osseointegration in a tibia model of spontaneously hypertensive rats. / 16/03245-2

Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-03-16Bitstream added on 2014-06-13T20:08:38Z : No. of bitstreams: 1 faeda_rs_me_arafo.pdf: 1508242 bytes, checksum: 76a3276ed9cd6a6e7947d633681c4217 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Universidade Estadual Paulista (UNESP) / O sucesso dos sistemas modernos de implantes dentais tem sido relacionado ao desenvolvimento do design e das características de superfícies dos implantes. O propósito do presente estudo foi avaliar duas novas superfícies de implantes (modificada por laser - SML e recoberta por hidroxiapatita biomimética - HA), comparando-as a outros dois implantes comerciais, (superfície usinada - SU e modificada por jateamento e ataque ácido - SMC). Um total de 96 implantes (3,75 x 10mm), 24 de cada superfície, foram instalados na tíbia de coelhos e avaliados após 4, 8 e 12 semanas. Após os períodos de cicatrização os animais foram sacrificados, os implantes expostos e a força necessária para derosquea-los foi aferida por um torquímetro analógico. Em 4 e 8 semanas, os implantes HA apresentaram valor de torque de remoção estatisticamente superior (p<0,05) quando comparado aos demais, sendo o mesmo observado para os implantes SML quando comparados aos SU. Após 12 semanas, os implantes HA e SML foram estatisticamente superiores aos implantes SU. Os resultados deste estudo sugerem que os implantes HA foram superiores aos demais nos períodos iniciais, obtendo uma estabilidade satisfatória com 4 semanas de implantação. Os implantes SML foram superiores aos SU em todos os períodos avaliados, porém não apresentando diferenças quando com parados aos SMC. / The success of modern dental implant systems has been associated with the development of implant designs and surface characteristic. The purpose of this study was to evaluate two new implant surfaces (laser-modified - LSM and biomimetic-hydroxyapatite coating - HA) comparing them with two other commercial implants (machined surface -MS and modified by sandblasted and acid etched - MCS). A total of 96 implants (3,75 x 10mm), 24 of each surface, were placed in rabbit tibia being evaluated after 4, 8 and 12 weeks. After the healing periods, the animals were sacrificed, the implants sites were exposed, and the needed force to unscrew the implants was measured using an analogical torque gauge. At 4 and 8 weeks, the HA implants removal torque was statistically greater (p<0,05) in comparison with the others, being the same observed to LSM when compared with MS. After 12 weeks, the HA and LSM implants were statistically greater just when compared with MS. The results of this study suggest that the HA implants were superior to the other at the initial periods, having a satisfactory stability with 4 weeks post-implantation. The LSM implants were superior to MS at all periods evaluated, but having no difference when compared with MCS.

Made available in DSpace on 2014-10-09T12:35:57Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T13:59:48Z (GMT). No. of bitstreams: 0 / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP