Biomedical subjects

C P Klein

Publications and source records attributed to C P Klein.

At least 37 records · Page 2Linked to original sources

PubMed1994

Calcium phosphate plasma-sprayed coatings and their stability: an in vivo study.

Several factors playing a possible role in determining coating stability and bone tissue response were studied in in vivo experiments. These factors involving the plasmaspray coating procedure were as follows: 1) plasmaspray powder port 2 or 6; 2) particle size distribution; 3) hydroxylapatite versus fluorapatite coatings; and 4) the effect of post-heat treatment. Coating stability and bone tissue response were examined by measuring coating thickness, coating length, and bone apposition against the coatings. The result was that heat treatment influenced coating stability significantly. Also, bone formation was more intense. Fluorapatite proved to be more stable than hydroxylapatite, which was in agreement with our previous reports.

Alloys↗

PubMed1994

Features of calcium phosphate plasma-sprayed coatings: an in vitro study.

Factors involved with the plasma-spray coating procedure, such as starting powder compound (fluorapatite, hydroxylapatite, magnesium-whitlockite, or tetra-calcium phosphate), powder particle distribution 1-45 or 1-125 microns), powder port gun (port 2 or 6), and post-heat treatment of 1 h at 600 degrees C, were examined for their effects on crystallinity and solubility/stability of the coating. From solubility tests, X-ray diffractometry, and scanning microscopy studies, the solubility and crystallinity were found to be dependent on Ca/P ratio, particle distribution, and post-heat treatment. The post-heat treatment influenced the degree of both crystallinity and solubility. The plasma-spray powder port factor for the hydroxylapatite coatings was not significant. Incubation in buffer of the coatings introduced precipitation at the surfaces of all non-heat-treated coatings except fluorapatite. No precipitation could be observed in any of the heat-treated coatings.

Calcium Phosphates↗

PubMed1994

Formation of a bone apatite-like layer on the surface of porous hydroxyapatite ceramics.

Phosphoric acid solution was used to react with commercial hydroxyapatite (HA) powders to demonstrate the possibility of converting HA to non-stoichiometric apatite and thus to treat porous HA ceramics, to form a thin bone-apatite like layer on the HA ceramic surface. Such a carbonate-containing non-stoichiometric apatite "bioceramic" would be more efficient in bone bonding or bone formation, due to its analogy to natural bone apatite.

Bone and Bones↗

PubMed1994

Histological observations of coated and prestressed dental implants under flexible or rigid loading conditions.

Hydroxyapatite-coated and hydroxyapatite-prestressed titanium implants were implanted under load-free, flexible-loaded and rigid-loaded conditions in dog mandibula in vivo. The bone response, bone contact and the quality of the coating were evaluated histologically and histometrically. Hydroxyapatite coating on titanium implants enhanced the bone apposition. The bone contact can still be present while the coating is resorbed. Gingiva contact with the coating led to a faster degradation of the coating. There was no significant difference in bone contact between hydroxyapatite-coated and -prestressed implants with regard to the loading systems: rigid, flexible and load-free. All three implants showed the highest amount of bone contact apically. Only at the mesial side of the implant did the flexible element show rather high amounts of bone contact compared to the rigid and load-free implants. The hydroxyapatite coating more or less degraded during the implantation period. The degree of degradation varied in the implant itself, between the implants and between the animals.

Analysis of Variance↗

PubMed1994

Long-term in vivo study of plasma-sprayed coatings on titanium alloys of tetracalcium phosphate, hydroxyapatite and alpha-tricalcium phosphate.

In order to study the interaction of calcium phosphate coatings with bone tissue, coated titanium plugs of standard size were implanted in dog femora. The bone bonding and bone formation of hydroxyapatite, alpha-tricalcium phosphate (alpha-TCP) and tetracalcium phosphate plasma-sprayed coatings were evaluated by mechanical push-out tests and histological observations after 3, 5, 15 and 28 months of implantation. During this time all coating types degraded. alpha-TCP showed the most significant degradation after 3 months of implantation. Hydroxyapatite and tetracalcium phosphate showed significant signs of degradation after about 5 months of implantation. All coatings showed a small increase in bone bonding after 5 months of implantation. In general, all types of implants showed similar bone response, some bone contact and several remodelling lacunae along the surfaces after long-term implantation.

Alloys↗

PubMed1994

Prophylactic sclerotherapy for esophageal varices in high-risk cirrhotic patients selected by endoscopic and hemodynamic criteria: a randomized, single-center controlled trial.

Controlled trials of sclerotherapy for the prevention of the first variceal hemorrhage in cirrhotics have given conflicting results, in spite of an initial positive controlled trial. We designed therefore a new study in which only 89 of 396 investigated patients were randomized to sclerotherapy (44 patients) or a control group (45 patients). The admission criteria were: no history of variceal bleeding, the presence of high risk varies, i.e., varices of degrees III and IV with minivarices on the surface of them, and portal pressure over 16 mmHg. Sclerotherapy sessions were performed at 0, 7, 14, 21, and 28 days, until the varices were reduced in size and completely covered by fibrous tissue. Follow-up endoscopy was performed at four-month and thereafter at six-month intervals. The control patients underwent repeated clinical investigation and endoscopy at six-month intervals. Bleeding episodes were treated by emergency endoscopic sclerotherapy in both groups, whenever possible. The mean follow-up was 33 months. The results were analyzed using Student's t-test and the log-rank test. Variceal bleeding occured in 11 sclerotherapy patients (25%) and 34 controls (75.6%) (p < 0.05). The overall mortality was 25% (11 patients) among the sclerotherapy patients and 69% (31 patients) in the controls (p < 0.01). Prophylactic endoscopic sclerotherapy was able to prolong survival in Child-Pugh classes A and B, but not in C. It is concluded that prophylactic endoscopic sclerotherapy does reduce the incidence of first variceal bleeding in cirrhotic patients, and is able to prolong survival if only high-risk patients are selected and the treatment is performed by endoscopic experts.

Adult↗

PubMed1993

[The effect of alcohol on portal vein hemodynamics in nutritional-toxic liver cirrhosis].

The influence of alcohol on portal vein haemodynamics was assessed prospectively in 30 patients (20 men, 10 women; mean age 54.3 [34-70] years) with nutritional-toxic cirrhosis of the liver (Child-Pugh stages A-C) and portal vein hypertension. During the period of observation hepatic vein occlusion pressure as an indirect measure of portal vein pressure was repeatedly determined. In addition, the size of oesophageal varices and the Child-Pugh stage were monitored. After complete alcohol abstinence of one year, portal vein pressure fell from 23.11 to 12.43 mm Hg (-46%, P < 0.001), the Child-Pugh score from 8.08 to 7.2 (-10.9%, not significant), and the size of oesophageal varices was reduced from grade 1.33 to grade 0.79 (-40%, P < 0.02). On resuming alcohol abuse, portal vein pressure increased by an average of 10 mm Hg (+60%, P < 0.001) to its previous level of 25 mm Hg. The portal vein pressure has thus proved to be a sensitive gauge of alcohol abstinence or abuse. Lasting, absolute alcohol abstinence is essential in nutritional-toxic liver cirrhosis.

Adult↗

PubMed1993

A histological and histomorphometrical investigation of fluorapatite, magnesiumwhitlockite, and hydroxylapatite plasma-sprayed coatings in goats.

Plasma-sprayed ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated histologically and histomorphometrically in a goat animal study. Cylindrical Ti-6Al-4V plugs were plasma-spray-coated with FA, MW, and HA. Noncoated, grit-blasted Ti plugs served as controls. The plugs were implanted into the right femur and left humerus of 20 adult goats. The results were evaluated using descriptive histology and histomorphometry. The histomorphometry consisted of measurements of bone apposition and coating thickness. The results demonstrated that FA showed a high amount of bone apposition without signs of degradation or dissolution. MW showed considerable reduction in thickness and at 12 weeks an adverse tissue reaction. However, at 25 weeks the amount of bone apposition was significantly increased compared with the 12-week implants. HA revealed considerable and progressive reduction in thickness and at 25 weeks a lower amount of bone apposition than FA and MW. At 12 weeks the Ti implants did reveal bone apposition, although frequently localized fibrous tissue was visible. At 25 weeks the Ti implants did not differ in bone apposition from the HA implants. Further studies are necessary on the effect of degradation or dissolution of HA on the compatibility with bone.

Alloys↗

PubMed1993

Relationship between the colour change of hydroxyapatite and the trace element manganese.

Hydroxyapatite containing the trace element manganese turns blue after sintering at high temperature in an oxidizing atmosphere. This phenomenon is related to the oxidation of manganese ions in the special crystal structure of hydroxyapatite. Combination of the crystal structure with electron spin resonance spectra gives an explanation for this oxidation of Mn2+ ions at Ca(l) sites into Mn5+ ions and the formation of MnO4(3-) ions at PO4(3-) sites, corresponding to the colour change of hydroxyapatite.

Calcium↗

PubMed1992

A finite element analysis of the push-out test: influence of test conditions.

The commonly used method for quantitative evaluation of the strength of a bone-implant interface is the push-out test. In order to give an impulse to standardization and to gain more insight in the biomechanics of the push-out test, a finite element analysis of this test was performed. This study focused on the influence of test conditions on the push-out results. The influence of the following four parameters on the interface stress distribution was tested: (a) clearance of the hole in the support jig, (b) Young's modulus of the implant; (c) cortical thickness; and (d) implant diameter. The distance between the implant and the support jig turned out to be very critical for the occurrence of peak stresses in the interface. Variations of the Young's modulus of the implants resulted in a wide range of interface shear stresses. Variation of the cortical thickness showed a reciprocal relationship between cortical thickness and interface shear stress. However, the interface stress distribution remained uniform under the specific test circumstances. These findings also hold for variations in implant diameter. The present investigation shows that the clearance of the hole in the support jig, and the Young's modulus of the implant are parameters which most strongly influence the interface stress distribution. The clearance of the hole in the support jig is the most critical parameter, but also the parameter that can be controlled most easily. Lack of standardization with regard to these parameters can lead to uninterpretable test results. It is recommended that the clearance of the hole in the support jig is at least 0.7 mm and that push-out results are only compared with each other when materials with similar Young's modulus are concerned.

Animals↗

PubMed1992

Bone induction by demineralized bone particles: long-term observations of the implant-connective tissue interface.

Allogeneic demineralized bone (DB) powder was applied to subcutaneous pockets and cranial defects of rats and histological, histomorphometrical, and radiological evaluation was performed one to 52 weeks after implantation. In both type of implants cartilage formation was observed after 1 week between DB particles and in former vascular channels and cervices within the particles. Foci of bone formation were observed after 2 weeks in the center of the implant. Remineralization of DB particles only occurred in close contact with the new bone tissue by which they became incorporated, indicating that remineralization of DB is a continuation of a process which has started in live bone. At all times, the interface between implant and connective tissue of the host consisted of a layer of non-remineralized DB particles embedded in fibrous connective tissue. This rim was thinner at the dura-mater-side in the cranial implants, compared with the skin-side of the same implants as well as all sides of the subcutaneous implants. The rim became thinner with time but never disappeared completely. The outer contour of the mineralized implant sometimes ran right through a DB particle. A critical concentration of bone-inducing agent leaking from DB particles seems to be necessary for bone induction. We suggest that at the interface of the implant and loose connective tissue this concentration is never reached, which results in maintenance of the rim.

Animals↗

PubMed1992

The ultrastructure of the bone-hydroxyapatite interface in vitro.

Rat bone marrow cells were cultured on plasma-sprayed hydroxyapatite (HA). The cells formed a mineralized extracellular matrix (ECM) that exhibited several characteristics of bone tissue. The interface between this mineralized ECM and the HA was studied at the ultrastructural level with scanning and transmission electron microscopy and x-ray microanalysis. Initially, the deposition of a globular, afibrillar matrix was observed on HA. This was followed by the integration of collagen fibers in this matrix and their subsequent mineralization. At the bone-HA interface two distinctly different interfacial structures were observed. An electron-dense layer with a thickness of 20-60 nm was regularly present, which contained both organic and inorganic material and was rich in glycosaminoglycans. The interfaces differed however, in the presence or absence of an amorphous zone which was free of collagen fibers and had an average thickness of 0.7-0.8 microns. It was frequently seen interposed between the electron-dense layer and the hydroxyapatite. Similar interfacial structures have also been described in the in vivo environment, where they were referred to as lamina limitans-like or cement linelike. From the results of this study, it can be concluded that the described in vitro system is a suitable model to study bone-biomaterial interactions.

Animals↗

PubMed1992

Permucosal implantation pilot study with HA-coated dental implant in dogs.

The histological response of transmucosal one-stage titanium dental implants coated with hydroxyapatite is described. The gingival adhesion to the implant was examined with regard to coated, partially coated or non-coated surfaces in the cervical region. From each coating type, 9 implants were inserted into dogs. Six months after the insertion, 19 implants could be evaluated, but 8 implants were lost. From these 19 implants, 6 implants showed severe pockets with inflammation up to the bony tissue. The 13 successful implants showed direct bone bonding with the hydroxyapatite coating and adhesion of submucosal connective tissue to the implant surface, with inflammation. The marginal gingiva showed slight inflammation. A totally coated implant will probably introduce inflammation by debris formation against the rough implant surface more easily. The hydroxyapatite coating often disappeared in the soft tissue or in the oral cavity. Bone which directly adapted to the coating seemed to prevent it from resorption.

Animals↗

PubMed1991

Plasma-sprayed coatings of tetracalciumphosphate, hydroxyl-apatite, and alpha-TCP on titanium alloy: an interface study.

In order to study the interaction of calcium phosphate coatings with bone tissue, coated titanium cylinders with a standard size were implanted in dog femora. Coatings were made by plasma spraying powders of hydroxylapatite, beta-whitlockite, and tetracalciumphosphate particles. The plasma spraying process turns beta-whitlockite into alpha-TCP. Bone bonding and bone formation were evaluated by mechanical push-out tests and histological observations. Hydroxylapatite and tetracalciumphosphate coatings show an interface strength after 3 months of implantation of 34.3 +/- 6.5 MPa and 26.8 +/- 3.9 MPa, respectively, while alpha-TCP and blanco titanium lead to an interface strength of 10.0 +/- 3.5 MPa and 9.7 +/- 1.3 MPa, respectively. Histological examinations revealed that hydroxylapatite and tetracalciumphosphate give rise to an excellent bone formation, while alpha-TCP and blanco titanium evoked remodeling and less bone contact.

Alloys↗

PubMed1991

A mechanical investigation of fluorapatite, magnesiumwhitlockite, and hydroxylapatite plasma-sprayed coatings in goats.

Ceramic coatings of fluorapatite (FA), magnesiumwhitlockite (MW), and hydroxylapatite (HA), and noncoated Ti-6Al-4V alloy (Ti) implants were evaluated before and after implantation in an animal study. Cylindrical plugs were coated by plasma-spraying with FA, MW, and HA. X-ray-diffraction patterns showed for FA and HA a crystalline and for MW an amorphous-crystalline coating structure. The plugs were implanted into the right femora and left humeri of 16 adult goats. Follow-up periods were 12 and 25 weeks. The in vivo results were evaluated using push-out tests and scanning electron microscopy. There were significant differences in push-out strengths between femur and humerus. The FA and HA implants showed significantly higher push-out strengths than the MW and Ti alloy implants, especially for the 12 week follow-up period. Furthermore, at 12 weeks, MW showed significantly lower push-out strengths than Ti alloy. SEM-investigation of the interfaces revealed that FA did not degrade while both MW and HA showed extensive degradation at 12 and 25 weeks. In addition, the interface after push-out testing showed for the MW, HA, and Ti alloy implants to be fractured at the implant-tissue interface and for the FA to be fractured at the coating-titanium interface.

Animals↗

PubMed1991

Macroporous calcium phosphate ceramics for bone substitution: a tracer study on biodegradation with 45Ca tracer.

The value of artificial materials in bone replacement depends highly on their biocompatibility and biostability. Porous calcium phosphate ceramics have a good compatibility with natural bone. To study the biodegradation process of calcium phosphate bioceramics, labelled [45Ca]-beta-whitlockite and [45Ca]-hydroxyapatite were implanted in the femurs of dogs. The effects accompanying the ingrowth of new bone into the pores of these bioceramics and its replacement by natural bone were investigated. In vivo degradation of the implant material by biochemical dissolution processes was observed. The beta-whitlockite implants showed a conspicuous decrease in radioactive calcium, in contrast to the hydroxyapatite implants. 45Ca was absent in adjacent bones and locally newly formed bone in both beta-whitlockite and hydroxyapatite suggesting a restricted availability of the 45Ca liberated in these processes. Indications of minor mechanical degradation of the materials were also found; in the lymph nodes a very small amount of 45Ca with a high specific activity was detectable. Urine, blood or faeces contained no detectable amounts of 45Ca activity.

Animals↗

PubMed1990

Studies of the solubility of different calcium phosphate ceramic particles in vitro.

In vitro solubility tests of hydroxyapatite, tetracalcium phosphate or tricalcium phosphate particles were performed in lactate, citrate, Gomoris or Michaelis buffer with pH 6.2 or 7.2 and in aqua destillata. The results showed that in general the solubility decreased in the order tetracalcium phosphate greater than tricalcium phosphate greater than hydroxyapatite, except for lactate or citrate buffer where the solubility order was tetracalcium phosphate = tricalcium phosphate greater than hydroxyapatite. The influence of the specific buffer used is much larger than either pH or specific calcium phosphate salt tested. The pH stability of lactate buffer and aqua destillata is very low, the other buffer solvents had a rather stable pH value.

Biocompatible Materials↗

PubMed1990

Histological evaluation of biocompatible orthopaedic polymer.

The biocompatibility of biocompatible orthopaedic polymer implant materials was studied in subcutaneous and bony tissue of rats and rabbits. The tissue response was evaluated by histological techniques. No bone induction capacity of biocompatible orthopaedic polymer could be observed. In rabbits, the presence of plasma cells was significantly higher than in rats. The biomaterial showed some signs of biodegradation and was not very biocompatible.

Animals↗