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Biomedical subjects

Peter Thomsen

Publications and source records attributed to Peter Thomsen.

21 records · Page 2Linked to original sources

Soft-tissue-anchored transcutaneous port for long-term percutaneous transhepatic biliary drainage.

PURPOSE: A transcutaneous port (T-port) has been developed allowing easy exchange of a catheter, which was fixed inside the device, using the Seldinger technique. The objective of the study was to test the T-port in patients who had percutaneous transhepatic biliary drainage (PTBD). METHODS: The T-port, made of titanium, was implanted using local anesthesia in 11 patients (mean age 65 years, range 52-85 years) with biliary duct obstruction (7 malignant and 4 benign strictures). The subcutaneous part of the T-port consisted of a flange with several perforations allowing ingrowth of connective tissue. The T-port allowed catheter sizes of 10 and 12 Fr. RESULTS: All wounds healed uneventfully and were followed by a stable period without signs of pronounced inflammation or infection. It was easy to open the port and to exchange the drainage tube. The patient's quality of life was considerably improved even though several patients had problems with repeated bile leakage due to frequent recurrent obstructions of the tubes. The ports were implanted for a mean time of 9 months (range 2-21 months). Histologic examination in four cases showed that the port was well integrated into the soft tissue. Tilting of the T-port in two cases led to perforation of the skin by the subcutaneous part of the ports, which were removed after 7 and 8 months. CONCLUSION: The T-port served as an excellent external access to the biliary ducts. The drainage tubes were well fixed within the ports. The quality of life of the patients was considerably improved. Together with improved aesthetic appearance they found it easier to conduct normal daily activities and personal care. However, the problem of recurrent catheter obstruction remained unsolved.

Aged↗

Long-term bone response to titanium implants coated with thin radiofrequent magnetron-sputtered hydroxyapatite in rabbits.

PURPOSE: The present study was designed to investigate the long-term bone response around machined screw-type uncoated and calcium phosphate (CaP) -coated commercially pure titanium implants. MATERIALS AND METHODS: Using a magnetron sputtering technique, implants with a CaP coating similar in composition and CaP ratio to hydroxyapatite were produced. Heat treatment was subsequently used to increase the crystallinity of the coatings. Four types of coatings (0.1 and 2.0 microm amorphous and 0.1 and 2.0 microm crystalline) were manufactured; uncoated implants served as a control. Three hundred twenty implants (64 of each type) were randomly placed in the tibial cortical and trabecular femoral bones of 40 rabbits. The rabbits were sacrificed 9 months after implant placement. RESULTS: Histomorphometric evaluation carried out on ground sections revealed that the crystalline CaP coatings achieved the highest bone-implant contact in both tibiae and femora compared with amorphous CaP-coated and uncoated titanium. DISCUSSION: The present study suggests that submicron crystalline hydroxyapatite coating adds bioactive properties to titanium oral implants. CONCLUSION: An ultra-thin, 0.1-microm crystalline CaP coating can elicit and maintain an improved long-term bone response compared to amorphous coated or uncoated Ti implants, without any adverse tissue reactions.

Analysis of Variance↗

A 5-year follow-up comparative analysis of the efficacy of various osseointegrated dental implant systems: a systematic review of randomized controlled clinical trials.

PURPOSE: To test the null hypothesis that there is no difference in failure rates between various root-formed osseointegrated dental implant systems after 5 years of loading. MATERIALS AND METHODS: A search was conducted for all randomized controlled clinical trials (RCTs) comparing different implant systems with a follow-up of 5 years. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, and EMBASE were searched. Several dental journals were also searched by hand. Written contacts were established with authors of the identified RCTs and with more than 55 oral implant manufacturers and personal contacts to identify unpublished RCTs. No language restriction was applied. The last electronic search was conducted on February 1, 2005. Screening of eligible studies, quality assessment, and data extraction were conducted in duplicate. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals. RESULTS: Ten RCTs were identified. Four of these RCTs, reporting results from a total of 204 patients, were considered suitable for inclusion. Six different implant types were compared. On a per-patient rather than a per-implant basis, there were no statistically significant differences, with the exception of more marginal bone loss around early loaded Southern implants when compared to early loaded Steri-Oss implants (mean difference -0.35 mm; 95% CI -0.70 to -0.01). However, the difference disappeared in the meta-analysis. DISCUSSION AND CONCLUSIONS: There were no clinical differences among implant systems. However, these findings are based on only 4 RCTs with few participants. More RCTs should be conducted with larger patient samples.

Dental Implantation, Endosseous↗