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Biomedical subjects

T Albrektsson

Publications and source records attributed to T Albrektsson.

At least 19 recordsLinked to original sources

Titanium implants and BMP-7 in bone: an experimental model in the rabbit.

This study evaluates the effect of rhBMP-7/OP-1 on the osseointegration of commercially pure titanium implants in an experimental implant model in rabbits. Threaded titanium implants with two transverse parallel canals were inserted in the femur and tibia of rabbits. The canals were filled with, 10 microg of BMP-7/collagen carrier, pure collagen carrier or were left empty as a control. The stiffness of the implant fixation was evaluated by Resonance Frequency Analysis (RFA) at baseline and four weeks postoperatively. Percentage of bone ingrowth in the canals was measured on microradiographs. Histomorphometry along the threaded part of the implants was performed on 15 microm thin sections. The results from the RFA demonstrated a higher mean value for the BMP-7 treated implants in the tibia than the carrier treated implants but not compared to the control implants. The control implants in the tibia demonstrated more bone ingrowth in the upper canal than to the carrier or the BMP-7 treated implants. Apart from these differences there were no significant effects of BMP. In this study BMP-7 did not contribute to any substantially improved bone anchorage of titanium implants.

Journal Article↗

Tissue reactions adjacent to well-fixed hydroxyapatite-coated acetabular cups. Histopathology of ten specimens retrieved at reoperation after 0.3 to 5.8 years.

Ten acetabular cups coated with hydroxyapatite (HA) had originally been inserted in five primary and five revision total hip replacements. The thickness of the HA was 155 +/- 35 microm. The cups, which were well-fixed, were retrieved, with their adherent tissue, at reoperation after 0.3 to 5.8 years because of infection (five hips), wear of polyethylene (three hips), and instability (two hips). Undecalcified sections showed a direct contact between bone and osteoid-like tissue which had formed directly onto the HA coating. The area within the threads and their mirror images, as well as the implant-tissue interfaces consisted of similar amounts of bone and soft tissue. Degradation of HA was seen in all hips. The mean thickness of the remaining HA coating was 97 microm (95% CI 94 to 101). The metal interface comprised 66% HA. The HA-tissue interface contained more bone than soft tissue (p = 0.001), whereas the metal-tissue interface included more soft tissue than bone (p = 0.019). Soft tissue at the implant interface and poor replacement of HA by bone may interfere with long-term fixation.

Acetabulum↗

Osteoinduction, osteoconduction and osseointegration.

Osteoinduction is the process by which osteogenesis is induced. It is a phenomenon regularly seen in any type of bone healing process. Osteoinduction implies the recruitment of immature cells and the stimulation of these cells to develop into preosteoblasts. In a bone healing situation such as a fracture, the majority of bone healing is dependent on osteoinduction. Osteoconduction means that bone grows on a surface. This phenomenon is regularly seen in the case of bone implants. Implant materials of low biocompatibility such as copper, silver and bone cement shows little or no osteoconduction. Osseointegration is the stable anchorage of an implant achieved by direct bone-to-implant contact. In craniofacial implantology, this mode of anchorage is the only one for which high success rates have been reported. Osseointegration is possible in other parts of the body, but its importance for the anchorage of major arthroplasties is under debate. Ingrowth of bone in a porous-coated prosthesis may or may not represent osseointegration.

Bone Development↗

The electrochemical oxide growth behaviour on titanium in acid and alkaline electrolytes.

Titanium implants have a thin oxide surface layer. The properties of this oxide layer may explain the good biocompatibility of titanium implants. Anodic oxidation results in a thickening of the oxide film, with possible improved biocompatability of anodized implants. The aim of the present study was twofold: (1) firstly, to characterize the growth behaviour of galvanostatically prepared anodic oxide films on commercially pure (c.p.) titanium and (2) secondly, to establish a better understanding of the electroche0mical growth behaviour of anodic oxide on commercially pure titanium (ASTM grade 1) after changes of the electrochemical parameters in acetic acid, phosphoric acid, calcium hydroxide, and sodium hydroxide under galvanostatic anodizing mode. The oxide thickness was measured by Ar sputter etching in Auger Electron spectroscopy (AES) and the colours were estimated by an L*a*b* system (lightness, hue and saturation) using a spectrophotometer. In the first part of our study, it was demonstrated that the interference colours were useful to identify the thickness of titanium oxide. It was also found that the anodic forming voltages with slope (dV/dt) in acid electrolytes were higher than in alkaline electrolytes. Each of the used electrolytes demonstrates an intrinsically specific growth constant (nm/V) in the range of 1.4--2.78 nm/V. In the second part of our study we found, as a general trend, that an increase of electrolyte concentration and electrolyte temperature respectively decreases the anodic forming voltage, the anodic forming rate (nm/s) and the current efficiency (nm.cm(2)/C), while an increase of the current density and the surface area ratio of the anode to cathode increase the anodic forming voltage, the anodic forming rate and the current efficiency. The effects of electrolyte concentration, electrolyte temperature, and agitation speed were explained on the basis of the model of the electrical double layer.

Acetic Acid↗

Growth of costochondral grafts in reconstruction of the mandibular condyle: an experimental study in domestic pigs.

Reconstruction of the mandibular condyle with costochondral grafts (CCGs) in children may result in overgrowth at the reconstructed side of the mandible. In this study we report on the effects of functional stimuli on growth and morphology of growth plates of CCGs used for immediate mandibular condyle replacement in 10 juvenile pigs. The mandibular condyles were resected unilaterally and immediately reconstructed with autogenous CCGs. Another CCG was placed submuscularly on one tibia. The lengths of both CCGs and of one rib before resection were measured at operation and 12 weeks later. The grafts were labelled with intraperitoneal injections of oxytetracycline and alizarin eight and 12 weeks postoperatively, respectively. The extent of growth of the CCGs in the two environments was similar, so we concluded that the functional stimuli in the TMJ environment had only a minor influence on the extent of growth of the CCGs. The morphology of the growth plate of the CCGs had changed considerably.

Animals↗

Application of oxygen ion implantation to titanium surfaces: effects on surface characteristics, corrosion resistance, and bone response.

BACKGROUND: The surface oxide layer of titanium plays a decisive role in determining biocompatibility. However, there are some reports demonstrating that the natural oxide film may not be sufficiently protective in the aggressive biologic environment. PURPOSE: The goal of this study was to examine the effectiveness of a thick oxide layer on corrosion resistance in vitro and the bone formation around titanium implants in vivo. MATERIALS AND METHODS: A plasma source ion implantation (PSII) method was used to increase the thickness of the surface oxide layer. Several instruments were employed to confirm the surface properties before and after the surface modification. Potentiodynamic polarization measurements in a phosphate-buffered saline (PBS) solution were carried out to investigate corrosion resistance in vitro. Bone formation around this surface-modified specimen was examined in a rabbit model and assessed in histomorphometry. RESULTS: Improved corrosion resistance was demonstrated by the potentiodynamic polarization measurements. Light microscopic histomorphometry showed that all implants were in contact with bone and had some proportion of bone within the threads at 4 weeks; however, there were no significant differences compared with as-machined controls. CONCLUSIONS: The results indicate that in spite of improved corrosion resistance in vitro, a thick oxide layer fabricated with the PSII method does not influence early bone formation around titanium implants in vivo.

Animals↗

Revascularisation of costochondral grafts: an experimental study in domestic pigs.

Mandibular condyles are reconstructed immediately with costochondral grafts (CCGs) in children for several temporomandibular conditions, including ankylosis, benign neoplasia, and chronic arthritis. A prerequisite for growth of CCGs is that they are properly revascularised, but the revascularisation process has not to our knowledge so far been examined. The aim of the present study was therefore to investigate the revascularisation of CCGs when they were used for immediate reconstruction of the mandibular condyle in juvenile domestic pigs. Eleven mandibular condyles were experimentally resected and immediately reconstructed with CCGs. Microangiograms with an Indian ink solution were done 2, 4, 8, and 12 weeks after the reconstructions. The density of vessels was higher in measurement zones facing soft tissues than in those facing mandibular bone at all time points. Revascularisation of the growth plate originated from the surrounding recipient soft tissues and not from an endosteal blood supply from the host mandible ramus.

Animals↗

A new approach to demonstrate cellular activity in bone formation adjacent to implants.

Bone tissue repeatedly formed in titanium 6-aluminum 4-vanadium rabbit bone harvest implants was collected in vivo at various times between 12 days and 5 weeks. Qualitative and quantitative examinations on undecalcified thin sections were performed in the light microscope. The amount of bone tissue was calculated on routinely stained sections. Alkaline (ALP) and acid phosphatase (ACP) enzyme activities were investigated. We also performed immunohistological detection of bone matrix proteins. Increasing bone density as well as an increasing mineralization of the tissue was observed in the biopsies with increasing time. The ALP and ACP activities were similar at short times (12 days and 2 weeks). With increasing time the ALP activity was stronger than that of ACP. The results from the immunohistochemical detection of osteonectin, osteopontin, bone sialoprotein, and collagen I and II demonstrated changes in the tissue differentiation with time. The tissue formation in the canal became more mature with time of ingrowth, as observed with the various techniques used in this study. Owing to these methodical developments, undecalcified ground sections may be used for detailed analysis of various phases of tissue formation in close proximity to implants.

Acid Phosphatase↗

Chemical and topographical surface analysis of five different implant abutments.

The surface characteristics of the dental implant abutment which penetrates through the gingival mucosa and is exposed to the oral cavity play an important role not only for the biocompatibility but also for the bacterial adhesion and stagnation. The purpose of this study was to investigate the surface characteristics of 5 commercially available implant abutments which were Brånemark (Nobel Biocare, Gothenburg, Sweden), Astra (AstraTech, Mölndal, Sweden), IMZ (Friatec, Mannheim, Germany), STERI-OSS (Denar, CA, USA) and POI (Kyocera, Kyoto, Japan). The three dimensional imaging and analysis of the surface topography were carried out using a confocal laser scanning profilometer (TopScan 3D). The chemical composition of abutment surfaces was analyzed by Auger Electron Spectroscopy (AES). The results indicated that quite different surface features were shown in three dimensional images. These features reflected roughness parameters. Sa and Scx values of these abutments in micron were Brånemark (0.23 +/- 0.09, 7.76 +/- 0.64), Astra (0.23 +/- 0.05, 7.92 +/- 0.25), IMZ (0.18 +/- 0.03, 7.76 +/- 0.80), STERI-OSS (0.15 +/- 0.01, 10.22 +/- 0.90) and POI (0.24 +/- 0.01, 8.08 +/- 0.77), respectively. The chemical elemental analysis showed all specimens to have thin titanium oxide layers (approximately 4 to 7 nm) except POI which is anodized titanium alloy, hence it has rather a thick oxide layer (95 to 110 nm). Some minor elemental traces (S, Si and P) were also seen on the outermost layer. The specimens which were investigated in this study varied in their topography and elemental composition. These variations were strongly due to the manufacturing processes which were milling, polishing, cleaning and sometimes oxidation methods.

Carbon↗

Bone healing around implants placed in a jaw defect augmented with Bio-Oss. An experimental study in dogs.

The present experiment was carried out to study some tissue reactions around implants that were placed in an edentulous ridge which had been augmented with deproteinized natural bovine cancellous bone mineral. In 4 male beagle dogs, the premolars in the right side of the mandible were extracted and a large buccal ridge defect was created by mechanical means. The bone plate at the lingual aspect of the defect was left intact. 5 months later, the distal 2/3 of the defect area was augmented with Bio-Oss (Geistlich Sons Ltd, Wolhusen, Switzerland) mixed with a fibrin sealer (Tisseel, Immuno AG, Vienna, Austria). After 3 months of healing, 3 fixtures (Astra Tech AB, Mölndal, Sweden; TiO-blast; 8x3.5 mm) were installed in the mandible; 2 were placed in the augmented portion and I was placed in the non-augmented portion of the defect. After a healing period of 3 months, abutment connection was performed and a plaque control period initiated. 4 months later, the dogs were sacrificed and each implant region was dissected. The tissue samples were dehydrated, embedded in plastic, sectioned in the bucco-lingual plane and examined in the light microscope. It was observed that osseointegration failed to occur to implant surfaces within an alveolar ridge portion previously augmented with Bio-Oss. In the augmented portion of the crest, the graft particles were separated from the host tissue as well as from the implant by a well-defined connective tissue capsule. Although the lingual aspect of all fixtures (test and control) was in contact with hard tissue at the time of installation, after 4 months of function, a deep vertical bone defect frequently had formed at the lingual surface of the implants. It was concluded that in this model (i) Bio-Oss failed to integrate with the host bone tissue and (ii) no osseo-integration occurred to the implants within the augmented portion of the crest.

Alveolar Ridge Augmentation↗

Histologic evaluation of retrieved craniofacial implants.

A retrieval study was performed on implants placed extraorally in the craniofacial region. The study included 19 implants retrieved from 16 patients. The implants were all stable at the time of removal. For various reasons, 5 of the implants were never loaded, whereas 14 of the implants had a known loading period of 3 months to 7 years 7 months. The reasons for removal varied but included the following: death in 1 case; poor results of the bone-anchored hearing aid in 7 cases; host-related reasons, varying from soft tissue irritation to infection or pain, in 6 cases; change of treatment plan in 1 case; and scheduled direct removal at the time of insertion in 1 case. The results of the histologic evaluation were similar to those reported in retrieval studies of a corresponding design used intraorally.

Adolescent↗

Clinical outcome of Screw Vent implants. A 7-year prospective follow-up study.

The clinical results of 85 Screw Vent implants are described with respect to 7-year success, including radiographically detectable bone loss, survival and prosthetic quality. The 1-year results of the same material have been reported previously (De Bruyn et al. 1992). Implants were considered as successful when they were meeting with the success criteria proposed by the European Academy for Periodontology. From the 85 implants originally installed, 16 failed during the 7-year interval (18.8%), 6 were unaccounted for (7%), 21 (24.7%) did not meet the success criteria yet survived and 42 implants (49.4%) were successful. The success rate was 65.2% for the mandibular and 43.5% for the maxillary implants. Implant failures were irrespective of implant length, smoking habits, prosthetic quality or oral hygiene level. From 24 patients with a corresponding number of 60 implants, radiographs were available for bone loss analysis. The mean bone loss after 7 years was 2.92 mm (range -0.5 to 6.3) 18 out of 60 examined implants (30%) showed unacceptable radiological bone loss beyond the critical value of 2.7 mm. Implant material analysis and histomorphometric analysis of a retrieved implant are discussed. In the present clinical study, the Screw Vent implant system does not meet the success criteria proposed by the European Academy for Periodontology. The ongoing bone loss increases the risk for future implant failures and peri-implant disease.

Alveolar Bone Loss↗

Bone tissue reaction around implants placed in a compromised jaw.

The present experiment was carried out to examine bone tissue alterations that occurred around implants at which the marginal level of bone support at fixture installation was different at buccal and lingual surfaces. 8 beagle dogs were randomly divided into one test group and one control group. The mandibular premolars in the left side of the mandible (P1, P2, P3, P4) were extracted. In the 4 dogs of the test group, the buccal bone plate in the mandibular premolar region was removed to establish a bone defect that was about 25 mm long, about 5-6 mm high, and about 4 mm wide. In the 4 dogs of the control group, no bone resection was performed. 8 months after tooth extraction, 3 fixtures (Astra Tech AB, Mölndal, Sweden:TiO-blast: 8x3.5 mm) were installed in each dog. In the 4 dogs of the test group, the implants were positioned in the defect sites in such a way that (i) mechanical stability was achieved and (ii) their lingual surfaces were entirely invested in bone. At the buccal and approximal surfaces of the fixtures, however, the unthreaded portion (2 mm) and the 3 marginal threads remained exposed. In the control group, all implants were following installation entirely surrounded by bone tissue. After a healing period of 3 months, abutment connection was performed and a plaque control program initiated. 4 months later, the dogs were sacrificed. The mandibles were removed and placed in a fixative. Each implant region was dissected, the tissue samples were dehydrated, embedded, sectioned in a bucco-lingual plane and used for light microscopic examination. The findings demonstrated that osseointegration occurred at implants, placed in a chronic defect with large discrepancies between the buccal and lingual bone. During the process of healing and function, however, marked modeling and remodeling of the bone tissue took place. Thus, at the buccal surface, some bone regrowth and osseointegration occurred while at the lingual wall, there was a substantial resorption of the marginal bone and an enhanced number of bone multicellular units. Concomitant with the bone tissue alterations described, there was some recession of the peri-implant mucosa.

Animals↗

Bone-tissue formation and integration of titanium implants: an evaluation with newly developed enzyme and immunohistochemical techniques.

BACKGROUND: Examination of the tissue surrounding retrieved implants involve routine investigations on cut and ground sections. Undecalcified sections with implants in situ are histologically stained followed by qualitative and quantitative observations of the tissue response to the implants by light microscopy. PURPOSE: A novel technique that allows for the accurate definition and quantification of enzymes involved in bone formation (alkaline phosphatase) and resorption (acid phosphatase) in the tissue is presented. MATERIALS AND METHODS: Commercially pure titanium and titanium alloy (Ti6Al4V) implants were retrieved after 6 and 12 weeks of healing in rabbit bone. In addition, 4-week specimens from commercially pure titanium bone harvest chambers placed in rabbit bone were used. Undecalcified cut and ground sections were produced and evaluated with enzyme and immunohistochemical staining techniques. RESULTS: The titanium implants retrieved after 6 weeks of insertion in rabbit bone revealed a higher activity of both alkaline phosphatase and acid phosphatase activity compared to the implants followed for 12 months. The former samples revealed ongoing bone-tissue remodeling in the interface, whereas the latter ones showed steady-state bone conditions. Applying the new technique allowed for investigation of various bone proteins present in the tissue that had formed inside titanium canals of harvest chambers at various times of follow-up. CONCLUSIONS: The combination of routine histologic stainings with enzyme and immunohistochemical technique of cut and ground specimens is a valuable tool in the investigations of retrieved implants from humans and animals. This novel technique now may be used to describe the state of bone regeneration in the interface zone associated with implant research.

Acid Phosphatase↗

Atomic force microscopic study of commercially available implant abutments.

BACKGROUND: Clinical studies have reported a correlation between the surface roughness of implant abutments and the rate of supragingival and subgingival plaque formation. In order to maintain periimplant health, it is important to understand the relationship between abutment surface characteristics and plaque formation. PURPOSE: The aim of this study was to use high image resolution imaging techniques for analysis of implant abutment surface topography. MATERIALS AND METHODS: Five commercially available implant abutments (Brånemark, Nobel Biocide, AB, Goteborg, Sweden, Astra, Astra Tech AB, Mondal, Sweden, IMZ, Friatec AG, Mannheim, Germany, Steri-Oss, Denar Corp, Anaheim, Calif, USA, and POI, Kyocera Corp, Kyoto, Japan) were visually and quantitatively characterized using an atomic force microscope. RESULTS: Statistical analysis by analysis of variance and Fishers's Protected Least Significant Differences showed significant differences (p < .05) between arithmetic mean deviation values of surface relative to the center plane (Sa). Power spectral density analysis also was effective as a spacing parameter. Sectional profiles measured the exact length, depth, or height of the specific features on the images. CONCLUSIONS: Within the limits of this study, the Brånemark, Astra and IMZ abutments displayed turning marks in x direction from the procedure. The Steri-Oss abutment showed smoothest surface among the five abutments tested.

Analysis of Variance↗