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Bioresorbable plain and ciprofloxacin-releasing self-reinforced PLGA 80/20 implants' suitability for craniofacial surgery:histological and mechanical assessment

Abstract
Ciprofloxacin was incorporated to plain bioresorbable self-reinforced polylactide/glycolyde 80/20 screws and tacks (ciprofloxacin releasing SR-PLGA). These implants were compared to otherwise similar conventional fixation devices. The effect of the ciprofloxacin addition on the pull-out force of screws and tacks was evaluated in human cadaver cranial bones. SR-PLGA tacks applied to cranial bone with a special applicator gun had a similar holding power as screws. Addition of the antibiotic compromised the strength of the screws so that ciprofloxacin-containing PLGA screws had lower pull-out strength than corresponding plain PLGA screws. Scanning electron microscopy showed that the fibrillar strip-like microstructure of plain SR-PLGA screws turned into a coarse uni-axial platelet-like pattern as a result of ciprofloxacin addition. It is concluded that this type of 4 mm long and 1.5 mm diameter ciprofloxacin-containing screws can only be used in non-load-bearing or slightly load-bearing applications. Tissue reactions elicited by plain bioresorbable self-reinforced polylactide/glycolide (SR-PLGA) 80/20 screws were compared to similar but ciprofloxacin-releasing SR-PLGA fixation devices in rabbit cranial bone. Plain and ciprofloxacin-PLGA 80/20 screws elicited only mild inflammatory reactions upon implantation in rabbit cranial bone, but they did not interfere with osteoblast activity in up to 72 week long follow-up. Release of the antibiotic from ciprofloxacin-PLGA screws was gradual and the drug concentration in bone tissues was still higher at 8 weeks than the minimal inhibitory concentration (MIC) of ciprofloxacin for S. aureus (0.1–1.0 μg/g). Ciprofloxacin-releasing SR-PLGA screws can find clinical usage in the prevention of implant-related infections in osteofixation in craniomaxillofacial bones in non-load-bearing or slightly load-bearing applications. Larger 6 mm long and 2 mm diameter ciprofloxacin-releasing tacks had a similar holding power to cranial bone as conventional tacks. Tacks can be recommended for clinical use as the application procedure saves time and costs.

Identiferoai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn978-951-42-8576-9
Date06 November 2007
CreatorsTiainen, J. (Johanna)
PublisherUniversity of Oulu
Source SetsUniversity of Oulu
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion
Formatapplication/pdf
Rightsinfo:eu-repo/semantics/openAccess, © University of Oulu, 2007
Relationinfo:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234

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