Introduction to Bio-Implants
S Santhosh Kumar, Somashekhar S. Hiremath in Role of Surface Modification on Bacterial Adhesion of Bio-Implant Materials, 2020
A significant cause for the implant failure is a fracture, prosthetic dislocation, loosening, excessive wear rate at mating surfaces and its associated debris, and pre-surgical contamination/infection (i.e., bacterial adhesion). American Joint Replacement Registry annual report (2018) collected between 2012and2017 showed that 8.2% of 47,378 hip arthroplasties and 7.9% of 40,488 knee arthroplasties are due to the infection and inflammatory reactions. The National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man surgical data of 2018 report shows that the overall 0.72% of hip replacement, 0.93% of knee replacement, and 6% of shoulder replacement results in implants-related infections. Similarly, it was reported in the Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR) annual report (2018) that, overall, less than 1% of revision of knee and hip arthroplasties accounts due to infection.
Ankle fractures
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Two other recent studies have shown similar results. Jonas et al.43 undertook a retrospective study of 31 patients with a mean age of 77 years. All were weight bearing 1 day after surgery and the majority were discharged from hospital within 2 weeks. There were three (9.7%) periprosthetic fractures and two (6.5%) broken nails. The authors stressed that there was a risk of implant failure in more active patients. Al-Nammari et al.44 treated 48 patients with a retrograde nail. There was one deep infection, four superficial infections and screw breakage occurred in three patients. They stressed that the main complications were medical, as shown in Table 42.2 for lateral plating, but they felt that the technique was very useful in the elderly frail patient.
Effect of drill speed on bone damage during drilling
R.M. Natal Jorge, J.C. Reis Campos, Mário A.P. Vaz, Sónia M. Santos, João Manuel R.S. Tavares in Biodental Engineering IV, 2017
Although not a novelty in medicine, the penetration of a sharp tool in the bone tissue continues to be a clinical and surgical challenge, as many pertinent questions still remain without solutions. Two major problems arising from drilling bone are the excessive temperature rise (resulting in thermal necrosis) and the excessive drilling force (resulting in mechanical damage) (Lee et al. 2012; Fonseca et al. 2014; Li et al. 2014; Fernandes et al. 2015). The mechanical damage that occurs around the drilled hole is a major concern during bone drilling, as greater the damage greater will be the postoperative healing time (Pandey et al. 2015). Also, it can lead to micro-cracks formations which are the prime source of reducing the bone postoperatively strength; and hamper the engagement of screws with the bone adjacent to the drilled hole leading to the loosening of fixation resulting in its misalignment (’Brien et al. 2005; Alam 2014; Pandey et al. 2015). Clinical problems such as implant failure, have been reported on the literature and are associated with these problems (Agustin et al. 2008; Penarrocha-Diage et al. 2009; Sezek et al. 2012). Improving and understanding the relationship between drilling conditions and the level of damage is crucial to identify the favourable drilling conditions which minimize the bone injuries. The importance of this problem has motivated the development of recent studies focusing on the problems caused by bone drilling (Marco et al. 2015).
Effect of the dimensions of implant body and thread on bone resorption and stability in trapezoidal threaded dental implants: a sensitivity analysis and optimization
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Mohammad Reza Niroomand, Masoud Arabbeiki
Biomechanical stability is a major factor of implant success in the first years after implantation, and periodontal health is the next priority (Chang et al. 2019). Even after the perfect integration of dental implant and providing suitable implant–bone interface, the successive and intense loading could increase the likelihood of dental implant failure. The higher the stress at the implant–bone interface, the more the possibility of bone resorption and implant failure (Haiat et al. 2014). Although the failure rate of the dental implant in healthy tissue might be low after a long period, the success of dental implants is of importance in the early stages of implantation (Ashrafi et al. 2020). Due to most of the clinical studies, implant failure could be the consequence of some reasons. It has been reported that an osseointegration failure may occur due to a fibrous tissue which could be a result of background oral diseases (I-Chiang et al. 2014).
Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis
Published in Acta Odontologica Scandinavica, 2018
Jungwon Lee, Dueun Park, Ki-Tae Koo, Yang-Jo Seol, Yong-Moo Lee
One dichotomous (yes/no) and five continuous implant-related outcome variables were evaluated as follows:Implant failure was expressed as the number of implants that failed to achieve osseointegration or removed after functional loading due to pain, mobility and severe peri-implant bone loss.MBL was an average of the mesial and distal bone loss calculated at baseline and the latest follow-up. If the average bone loss decreased (marginal bone gain) compared with that at baseline, the loss was expressed as a negative value.PD*.mBI*.MGL*.WKG*.
An age-related algorithm for management of micro-orbitism from anophthalmia: a systematic review with supplemental case reports
Published in Orbit, 2022
Brandon J. De Ruiter, Robert P. Lesko, M. Grace Knudsen, George Kamel, Jinesh Shah, Vikas S. Kotha, Anne Barmettler, Mark A. Prendes, Anand R. Kumar, Edward H. Davidson
Wiese et al. described their staged approach with osmotic implants for 4 orbits in 3 patients (age 5–11 mo.).15 Mimicking normal patterns of orbital maturity, osmotic expanders were placed first to stimulate conjunctival sac and eyelid growth and then placed serially to stimulate orbit growth. One complication was reported in a 6mo patient with bilateral anophthalmia who developed socket infection 3 days after implant placement. Gundlach et al. used the same protocol as Wiese et al. for 32 orbits in 22 patients (median age 4 mo., range 1–33 mo.) with congenital anophthalmia.18 By one and two years follow up, the mean orbital volume was 70% and 64% of the mean normal (non-anophthalmic) orbit volume, respectively, compared to 46% at 6 months age and before implant placement. Implant failure occurred in 21 (65.6%) cases over 6 years; a total of 78 implants were used. The authors suggest failure to incise the peri-implant capsule sizing-up expanders, neglecting to close the conjunctive in two layers, and improper perioperative antibiotic adherence as contributors to implant failure.
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