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The use of more biocompatible materials in comparison with silver, gutta-percha and amalgam was introduced a decade ago. First titanium was used, later followed by alumina. Both clinical as well as radiological results favor their use. Yet it appears that the system is mainly confined to the maxillary front teeth and mandibular canines.
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The use of more biocompatible materials in comparison with silver, gutta-percha and amalgam was introduced a decade ago. First titanium was used, later followed by alumina. Both clinical as well as radiological results favor their use. Yet it appears that the system is mainly confined to the maxillary front teeth and mandibular canines.
Biologic and non-biologic materials clinically used as hemostyptica, as vascular prostheses, or as temporary skin substitutes were implanted to the chick chorioallantoic membrane (CAM) during days 9-14 of incubation. The histological study revealed an intact CAM after application of cellulose gauze (Tabotamp). The fibrin tissue adhesive (Tissucol), the collagen sponge (Tachotop), or the gelatin sponge (Gelfoam) induced different amounts of connective tissue. Some fibroblasts were about to grow into the fibrin adhesive. Fibroblasts and capillaries filled the interstices of the collagen sponge poorly, and in the case of the gelatin sponge markedly. Neutrophils and giant cells of the foreign body type occurred more often in the gelatin sponge than in the collagen sponge. With regard to the non-biologic materials, expanded polytetrafluorethylene induced squamous metaplasia of the chorionic epithelium. Dacron caused ulceration with the onset of connective tissue ingrowth, based on a reaction of giant cells of the foreign body type. Polyurethane foam (SYSpur-derm) showed bleeding into the implant due to spikes of the material. Eosinophilic granulocytes were absent in all materials studied. The results are related to different clinical findings. The correlation allows consideration of the CAM as an in vivo model in screening materials for their biocompatibility and their connective tissue reaction.
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Congenital abdominal wall defects are impressive and dramatic malformations. Common surgical therapy for omphalocele and gastroschisis is to place the herniated viscera back into the abdomen and to close the fascia. Small defects can be closed directly by surgical treatment. In large defects, resorbable and non-resorbable artificial materials are necessary to close the fascia. The aim of this study is to find out whether new biocompatible materials might be suitable for the treatment of such abdominal wall defects. A median laparotomy was performed in young Wistar rats with a body weight of 75-100 g. Then a full thickness defect was created by excising a 1.5 x 2.5 cm segment including fascia, muscles and peritoneum. These defects were then closed by implantation of a PTFE mesh (Dual-Mesh, n = 6), a PPP mesh (Prolene, n = 6) or a new biocompatible mesh (NBM; Lyoplant, n = 6). Each rat was examined daily after treatment. Bodyweight was determined and the possible development of a hernia was monitored. After 6 weeks, the abdomen was opened again. Adhesions to the intestine were measured and the abdominal wall was removed for histological and tensiometric examination. (1) Compared to the untreated controls, all animals showed physiologic growth and normal bodyweight curve. (2) Only in one rat (Prolene) did an abdominal hernia develop. (3) In contrast to PTFE and PPP mesh, NBM showed only minimal adhesion to the intestine. (4) Tensiometry revealed high stability for non-resorbable materials. However, the characteristics of NBM were very similar to untreated abdominal wall. Our initial results indicate that biocompatible materials can also be used for the therapy of congenital abdominal wall defects.
We performed 43 open partial nephrectomies with different indications between 1996 and 2004, most of them (29) for renal cancer. We used different types of biocompatible materials for haemostasis. We describe our own recommendations and what is described in literature.
BACKGROUND: Nafamostat mesilate (FUT-175) is a synthetic serine protease inhibitor that inactivates coagulation, fibrinolysis, and platelet aggregation. Nafamostat mesilate may suppress the blood-foreign surface reaction similar to biocompatible materials by blocking factor XIIa. METHODS: We performed an in vitro study of cardiopulmonary bypass (CPB) with fresh human blood among the following three groups: standard CPB sets (C), biocompatible CPB sets (B), and standard CPB sets with FUT-175 (10 mg/L) (F). A clinical study using these same CPB groups also was performed in 45 patients undergoing aortocoronary bypass operations (15 patients each). We injected FUT-175 at 40 mg/h during CPB. RESULTS: In the in vitro study, both groups B and F showed significantly lower levels of coagulation factors, thrombin-antithrombin III complex, fibrinopeptide A, beta-thromboglobulin, complement C3a, granulocyte elastase, and free hemoglobin than group C at the conclusion of the study. Thrombin-antithrombin III complex and free hemoglobin in group F also were lower than in group B. The platelet count remained at a higher level in group F than in the other groups. Separation of bradykinin was suppressed most significantly in group F. In the clinical study, group F also showed significantly lower levels of alpha 2-plasmin inhibitor plasmin complex and C3a than both groups C and B. There were minimal levels of free hemoglobin in group F. CONCLUSIONS: Nafamostat mesilate may contribute major beneficial effects toward conservation of blood during CPB and prevention of coagulopathy after CPB.
BACKGROUND: This study was undertaken to investigate the safety and effect of DiHA, dextranomers in hyaluronan, a new biocompatible material for endoscopic treatment of stress incontinence, and to further develop the injection technique. METHODS: Twenty women aged 38 to 90 years with genuine stress incontinence participated. Seventeen were followed for a minimum of 6 months after treatment and three for a minimum of 3 months. The DiHA implants were administrered by transurethral endoscopically controlled submucosal injections under local anesthesia. Safety was assessed mainly in terms of infection, need for catheterization, residual urine and dysuria. The treatment efficacy was estimated objectively by a short-term pad test with standardized physical exercise and a 48 h pad-test, 7 days, and 1, 3 and 6 months after treatment. The patient's subjective experience of the effect was also studied. RESULTS: The implantation procedure was well accepted by the patients. Four patients required catheterization due to voiding problems during the first 24 postoperative hours. One patient had urinary retention 14 days postoperatively. No UTI or local infection was detected. Some patients had transient urgency. In 17 or 20 patients the treatment resulted in objective cure or improvement. CONCLUSIONS: This substance shows promising qualities for endoscopic treatment of stress incontinence.
PURPOSE: To study the biocompatibility of a bovine type I collagen preparation as a material for small-vessel stent-grafts in rabbits. MATERIALS AND METHODS: A composite nitinol-collagen endovascular stent-graft with a 4-mm inner diameter was deployed in the abdominal aorta in nine rabbits. Angiography was performed, and the rabbits were sacrificed at 1, 2, and 7 days and at 1 and 3 months. The portion of the aorta containing the stent-graft was excised and was histologically evaluated. RESULTS: All stent-grafts were patent at all time points. On days 1, 2, and 7 after implantation, scattered red and white blood cells adhered to the stent-graft. At 1 month, the stent-graft was endothelialized and was infiltrated with fibroblasts that deposited collagen within the interstices of the implanted collagen material. At 3 months, there was additional collagen deposition within the interstices of the stent-graft that did not narrow the lumen of the stent-grafts. CONCLUSION: Type I collagen as a intravascular stent-graft material is biocompatible for at least 3 months in rabbits. It is rapidly endothelialized and does not cause reactive stenosis. As a versatile and biocompatible polymer, collagen is potentially useful in the construction of endovascular stent-grafts for use in human arteries.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.