This study analyzes 35 patients with bisphosphonate-related osteonecrosis of the mandible (BRONJ) diagnosed and treated in the Oral and Maxillofacial Surgery Clinic of St. Spiridon Hospital Iasi. The inclusion criteria were in line with the recommendations of the American Association of Oral and Maxillofacial Surgery (AAOMS). The analysis included the underlying disease, the type of bisphosphonate and the route of administration, the duration of treatment as well as the osteonecrosis triggering factor. Surgery was consistent with the condition of the disease, ranging from debridement and sequestrectomy to alveolar marginal and even segmental bone resections. The results of the study were similar with the data from the literature suggesting that the condition is more common in the lower jaw compared to the upper jaw, and the main risk factors are dental extraction and intravenous bisphosphonate administration.
The treatment of bone defects in complex proximal tibial plateau fractures is a challenging situation and biphasic tricalcium phosphate (BCP) ceramics are considered the most promising alternative to autologous bone graft. The aim of the experimental part was to retrospectively asses the use of Atlantik� BCP (a mixture of 70% Hydroxyapatite and 30% beta-tricalcium phosphate) combined with plate osteosynthesis for management of 27 collapse tibial plateau fractures. All fractures healed after a mean time 2.8 months, while the mean time for disappearance the radiolucent zones between the implanted ceramic and receiving tissue was 15 weeks. We noticed a Neer score of 85 points with no reaction to bone substitute or evidence of biomaterial degradation. The study demonstrated that biphasic ceramic biomaterial Atlantik�, combined with supportive plate osteosynthesis, is an effective synthetic bone substitute due to a fast healing and good quality osseointegration.
One of the most popular and effective orthopedic surgical interventions for treating a variety of hip diseases is total hip arthroplasty. Despite being a radical procedure that involves replacing bone and cartilaginous surfaces with biomaterials, it produces excellent outcomes that significantly increase the patient’s quality of life. Patient factors and surgical technique, as well as biomaterials, play a role in prosthetic survival, with aseptic loosening (one of the most common causes of total hip arthroplasty failure) being linked to the quality of biomaterials utilized. Over the years, various biomaterials have been developed to limit the amount of wear particles generated over time by friction between the prosthetic head (metal alloys or ceramic) and the insert fixed in the acetabular component (polyethylene or ceramic). An ideal biomaterial must be biocompatible, have a low coefficient of friction, be corrosion resistant, and have great mechanical power. Comprehensive knowledge regarding what causes hip arthroplasty failure, as well as improvements in biomaterial quality and surgical technique, will influence the survivability of the prosthetic implant. The purpose of this article was to assess the benefits and drawbacks of various biomaterial and friction couples used in total hip arthroplasties by reviewing the scientific literature published over the last 10 years.
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