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Biomedical subjects

F Sutter

Publications and source records attributed to F Sutter.

At least 19 recordsLinked to original sources

[Migration of Kirschner wires after surgical stabilization of injuries in the area of the shoulder--4 case reports].

Internal fixation is recommended for displaced and unstable fractures of the lateral clavicle and fractures involving the proximal humerus. Kirschner wires, although recommended in the orthopedic literature bear the risk of wire breakage and migration. 4 cases with serious and potentially hazardous complications are presented. All reported complications occurred years after the operative treatment without clinical symptoms. Regular postoperative follow-ups and early hardware removal after fracture healing is recommended.

Adult

Effect of a prolonged low-dose lipopolysaccharide infusion on feed intake and metabolism in heifers.

Prolonged infusions of bacterial lipopolysaccharides (LPS) are known to model gram-negative bacterial infections, but the basic mechanisms of the LPS effects on feed intake and metabolism and their potential interdependence are largely unknown. The aim of the present study was to distinguish and to better characterize the feeding suppressive and metabolic effects of LPS. Six heifers were infused intravenously for 100 min with either 1) LPS (2 microg/kg BW) with free access to feed, 2) saline with free access to feed, or 3) saline with feeding restricted to the amount of feed consumed after LPS infusion. Feed intake, body temperature, plasma concentrations of various metabolites and hormones, and the respiratory quotient and heat production were measured. The LPS reduced feed intake and induced pronounced changes in metabolic energy turnover and fat and carbohydrate metabolism that were largely independent of the concomitant feed intake reduction. Some of the metabolic changes were biphasic; the first phase resembled a stress response with increases in plasma glucose and cortisol, and the second phase reflected a beginning energy deficit with low plasma glucose and enhanced lipolysis. The coincidence of a short-term surge of plasma insulin with marked transient decreases in plasma FFA, glycerol, and beta-hydroxybutyrate as well as with the transition from hyper- to hypoglycemia indicates that insulin plays a role in some of the metabolic responses to LPS. The failure of LPS to clearly increase energy expenditure despite the increase in body temperature suggests that anaerobic mechanisms of heat production and, perhaps, a reduced peripheral blood flow contributed to the fever. Many of the initial metabolic responses occurred before and, therefore, independent of, an increase in circulating tumor necrosis factor-alpha.

Adipose Tissue

Osseointegration of dental implants in bone irradiated with 40, 50 or 60 gy doses. An experimental study with beagle dogs.

Construction of different kinds of prostheses on irradiated bone tissues after tumour surgery is a complicated part of modern implantology. In irradiated regions of the jaws where the bone layers are thin and the blood supply also is minimal, knowledge of the impact of each dose of radiation is very important. The aim of this study was to compare the bone response around titanium implants loaded with fixed bridges in dog mandibles irradiated with total doses of 40, 50 or 60 Gy. The results suggest that after irradiation with 40-50 Gy, when the dose is fractioned in order to achieve higher tolerance of the tissues compared with single dose irradiation, titanium implants may become osseointegrated in the mandibles. For high success rates, however, careful planning of radiotherapy and selection of implantation site with an adequate blood supply are essential.

Animals

Titanium implants and lateral forces. An experimental study with sheep.

The purpose of this study was to investigate the resistance of titanium implants to horizontal forces in a sheep model. Twenty implants were inserted into the foreheads of 5 sheep, 4 implants on each animal. After a healing period of 3 months, abutments were mounted on the implants. After a further healing period of 3 weeks, the implants were loaded with a horizontal pull of orthodontic elastics. The force varied between 250 and 350 grams. The duration of loading was 3 months. After the loading period the animals were sacrificed and the forehead bones with implants were fixed in formalin and evaluated histologically. In the histological specimens no signs of infection or bone loss were found around the implants. The results of the present study encourage the use of titanium implants also in cases where constant lateral forces are present.

Animals

Implant dentistry--development and current focus.

Today, implant dentistry plays an important role in the maintenance of chewing function and oral health. For thirty years now oral implants and methods for implantation have been developed further to assure a lifetime stability of these devices and to optimize function and esthetics. Starting with the treatment of fully edentulous patients, oral implants are now used for the reconstruction of partially edentulous patients as well. Thereby, implants not only replace missing teeth but also help to preserve intact remaining teeth. They are usually incorporated to improve the patient's subjective chewing comfort. The present paper gives an overview of the development and the current state of the art of oral implants, as well as their clinical indications.

Animals

Characterisation of the acute phase response of heifers to a prolonged low dose infusion of lipopolysaccharide.

The effect of a prolonged low dose infusion of bacterial lipopolysaccharide (LPS) on acute phase-like reactions was examined in heifers. LPS (2 micrograms kg-1 dissolved in 100 ml water), or saline was infused (at 1 ml min-1) intravenously for 100 minutes and blood samples were taken at various times before, during and after the infusion. The serum concentrations of tumour necrosis factor-alpha (TNF alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and serum amyloid A (SAA) and the rectal temperature increased in response to the LPS infusion. Serum TNF alpha increased before the increases in IL-1 beta and IL-6 and remained high from 20 minutes after the onset of the infusion until the end of the sampling period (six hours). The LPS-induced increases in serum IL-1 beta and IL-6 were biphasic. Plasma cortisol and lactate concentrations also increased, and plasma glucose and beta-hydroxybutyrate concentrations decreased in response to the LPS infusion. The similarity of these reactions to changes observed in response to bacterial infections shows that the prolonged infusion of low doses of LPS is a good model for studying the acute phase response to Gram-negative bacterial infection in heifers.

Acute-Phase Proteins

Transversal fixation of restorations in combination with the Octa abutment of the ITI Dental Implant System.

In aesthetically demanding locations of the dentition, the replacement of a single tooth by means of an oral implant is often difficult because of technical limitations of the abutments systems used. The transversal Fixation System in combination with the Octa abutment of the ITI Dental Implant System presents a novel development to overcome these limitations. The report describes the engineering and design of this technical development.

Dental Abutments

Immediate transmucosal implants using the principle of guided tissue regeneration. I. Rationale, clinical procedures and 30-month results.

The installation of implants directly into extraction sockets offers considerable advantages over other treatment modalities for both practitioners and patients. Usually, immediate implants are placed and subsequently covered by mucosa allowing a submerged healing mode. This report presents the rationale, clinical procedures and results for immediate transmucosal implants. Following an intracrevicular incision and flap elevation, the tooth to be extracted is carefully luxated by means of small elevators to preserve the entire bony housing of the tooth. A titanium plasma-sprayed implant (ITI Bonefit) is then installed at the bottom or in the wall of the extraction socket. An expanded polytetrafluoroethylene barrier membrane (Gore-Tex GTAM) is tightly adapted around the implant post and over the bony margins of the alveolus. The flaps are then replaced, adapted around the neck of the implant and sutured. During nonsubmerged, transmucosal healing of the site, meticulous plaque control is performed by mechanical and chemical means. Membranes are removed after 5-7 months. Since infection was prevented, the implants obtained stability, healthy peri-implant mucosal tissues were observed and missing bone in the alveoli regenerated. Of 21 transmucosal implants placed into fresh extraction sockets, 20 yielded complete bone fill and coverage of the entire plasma-coated implants surface at the time of membrane removal. This documentation suggests that the immediate nonsubmerged installation of an implant into an extraction socket is a predictable treatment modality with good long-term prognosis.

Adult

ITI implants in combination with bone grafts: design and biomechanical aspects.

In this article we describe the implantation of ITI implants in combination with bone grafts. Two different cases were considered: the augmentation of an atrophic maxilla or mandible where the transplant was fixed by means of ITI implants and the implantation into free transplants fixed by means of the THORP reconstruction plate system. These indications require 2-stage procedures with submerged implants and transplants during the healing period. For this new applications, standard ITI implants were combined with specially developed new transgingival units of high manufacturing precision. The new design resulted in a maximum tightening moment of 4.0 N.m versus 1.25 N.m achievable with a conventional 2-mm screw. Dynamic testing showed that, for the range of tightening moments of 0.25 N.m up to 1.0 N.m, the loosening moment after 2,000,000 cycles remained approximately 10% above the tightening moment. For the clinical application a tightening moment of 0.35-0.5 N.m is recommended. The special design and the high precision of the extension parts results in a tight adaptation between the primary implant and the extension parts, which may be important for microbiological reasons.

Alveolar Ridge Augmentation

Indications for angled implants.

The development of dental implants has led to an expansion of indications and to perfection of implantation methods and implant systems. Angulation problems due to anatomic limitations, however, still remain. The indications for the use of angled Bonefit I.T.I. implants are described.

Alveolar Process

Classification and treatment of zygomatic fractures: a review of 1,025 cases.

The treatment of zygomatic fractures varies among surgeons, and the cosmetic and functional results are frequently less than optimal. A treatment guideline based on a simple classification of zygomatic fractures is presented. The emphasis is placed on the indications for closed and open reduction, consistent methods of three-dimensional alignment and fixation, and the management of concomitant infraorbital rim and orbital floor fractures. Postoperative results with regard to infraorbital nerve and maxillary sinus dysfunction, malar asymmetry, and orbital complications in the treatment of 1,025 consecutive zygomatic fractures are presented.

Adolescent

Atraumatic surgical technique and implant bed preparation.

The issues of bone necrosis and implant bed congruency are both central to the success or failure of endosseous dental implants to achieve osseointegration. Use of internally irrigated drilling instruments has been postulated to minimize bone necrosis. The ability of the cutting instruments to produce a smooth, congruent implant bed and retain fine bone structures is also critical to achieving primary integration. In the experiment conducted, the use of internally cooled instruments reduced the likelihood of thermal bone damage, particularly when trephine mills were used. Trephine mills were able to retain the fine bone structures of the walls of the implant bed site. No visible degradation occurred from multiple uses of the instruments.

Animals

Treatment of 813 zygoma-lateral orbital complex fractures. New aspects.

A 10-year experience with surgical treatment of 813 zygomalateral orbital complex fractures is reviewed. Regardless of the type or severity of the fracture pattern, concomitant fractures of the orbital floor and rim were approached exclusively through the transconjunctival approach without a lateral canthotomy. The advantages of this approach compared with the subciliary access are the avoidance of a visible scar and markedly reduced incidence of postoperative lower eyelid complications such as ectropion and edema. Implants of lyophilized dura or cartilage and autogenous bone were used to reconstruct orbital floor defects. Malar asymmetry is a frequent complication of zygoma fractures resulting from inadequate three-dimensional reduction. Methods for accurate reduction and stabilization, indications for closed and open reduction, and management of the fractured infraorbital rim are emphasized. The indications for miniplates vs wire ligatures for the infraorbital rim are discussed. Long-term follow up and evaluation of the results with regard to the fracture pattern, complications, maxillary sinus dysfunction, and facial and orbital symmetry are presented.

Bone Plates

Explantation procedure in the F-type and Bonefit ITI implant system.

The explantation technique for the ITI F-type and Bonefit implant system is described. Although implant survival rates are high, the risk of failure must be considered. In some cases implants will have to be removed for reasons other than failure of the implant itself.

Dental Implantation, Endosseous