A high prevalence of dental trauma exists and its effects on function and esthetics deserve the attention of general dentists. The aim of this study was to assess the level of general dental practitioners' (GDPs) knowledge about guidelines for dental avulsion and its prevention using a questionnaire. The 21-item questionnaire was distributed among 264 GDPs and the survey was realized between August-November 2006. The data obtained were statistically analyzed using descriptive analysis and Pearson's Chi-square test to determine associations between knowledge regarding emergency treatment and dentists from public or private dental schools and years of experience. The results showed that the participants exhibited appropriate knowledge concerning procedures in cases of tooth avulsion and its prevention. The number of correct answers was low in relation to recommended treatment at the site of injury. Storage medium, preparation of the alveolus and splint time for receiving the avulsed tooth received a high number of correct answers. One statistically significant association between years of experience and recommended treatment at the site of the injury in the case an avulsed tooth (chi(2) = 9.384, P = 0.009). In conclusion, this survey showed appropriate knowledge of dental avulsion management and its prevention among the surveyed dentists. The findings also showed that communication between dentists and the population is deficient, especially concerning practitioners of high risk and contact sports.
Porous titanium scaffolds are promising materials for biomedical applications such as prosthetic anchors, fillers and bone reconstruction. This study evaluated the bone/titanium interface of scaffolds with interconnected pores prepared by powder metallurgy, using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). Porous scaffolds and dense samples were implanted in the tibia of rabbits, which were subsequently killed 1, 4, and 8 weeks after surgery. Initial bone neoformation was observed one week after implantation. Bone ingrowth in pores and the Ca/P ratio at the interface were remarkably enhanced at 4 and 8 weeks. The results showed that the interconnected pores of the titanium scaffolds promoted bone ingrowth, which increased over time. The powder metallurgy technique thus proved effective in producing porous scaffolds and dense titanium for biomedical applications, allowing for adequate control of pore size and porosity and promoting bone ingrowth.
The fixation and the bone ingrowth at the interface of porous cylindrical implants (total porosity of 37% and average pores diameter of 480 microm) were compared in vivo to rough cylindrical implants (R (a) = 5.3 microm), both of commercially pure titanium, made by powder metallurgy. The implants were inserted into the tibias of 20 rabbits and the animals were sacrificed 4 and 8 weeks after surgery. The percentage of bone-implant contact observed in porous implant was significantly larger than in the rough ones for all of sacrifice periods, respectively, 57% vs. 46% after 4 weeks, and 59% vs. 50% after 8 weeks. The mechanical tests showed a significant increase in the shear strength of the porous implants for the two analyzed periods, 4 and 8 weeks (14 and 20 MPa), when compared with rough ones (4 and 13 MPa). These results suggest that porous implants improve the contact at the implant-bone interface and increase the fixation to the bone, improving the osseointegration. Thus, the porous implant might be an alternative to dental implant in less favorable conditions, and appear to be better fixed to bone, offering promising alternatives.
The purpose of this study was to analyze the bone repair around commercially pure titanium implants with rough and porous surface, fabricated using powder metallurgy technique, after their insertion in tibiae of rabbits. Seven male rabbits were used. Each animal received 3 porous-surface implants in the left tibia and 3 rough-surface implants in the right tibia. The rabbits were sacrificed 4 weeks after surgery and fragments of the tibiae containing the implants were submitted to histological and histomorphometric analyses to evaluate new bone formation at the implant-bone interface. Means (%) of bone neoformation obtained in the histomorphometric analysis were compared by Student's t-test for paired samples at 5% significance level.. The results of the histological analysis showed that osseointegration occurred for both types of implants with similar quality of bone tissue. The histomorphometric analysis revealed means of new bone formation at implant-bone interface of 79.69 ± 1.00% and 65.05 ± 1.23% for the porous- and rough-surface implants, respectively. Statistically significant difference was observed between the two types of implants with respect to the amount new bone formation (p<0.05). In conclusion, the porous-surface implants contributed to the osseointegration because they provide a larger contact area at implant-bone interface.
A porous material for bone ingrowth with adequate pore structure and appropriate mechanical properties has long been sought as the ideal bone-implant interface. This study aimed to assess in vivo the influence of three types of porous titanium implant on the new bone ingrowth. The implants were produced by means of a powder metallurgy technique with different porosities and pore sizes: Group 1 = 30% and 180 µm; Group 2 = 30% and 300 µm; and Group 3 = 40% and 180 µm. Six rabbits received one implant of each type in the right and left tibiae and were sacrificed 8 weeks after surgery for histological and histomorphometric analyses. Histological analysis confirmed new bone in contact with the implant, formed in direction of pores. Histomorphometric evaluation demonstrated that the new bone formation was statistically significantly lower in the group G1 than in group G3, (P = 0.023). Based on these results, increased porosity and pore size were concluded to have a positive effect on the amount of bone ingrowth.
A porous implant material with adequate pore structure and the appropriate mechanical properties for bone ingrowth has long been sought. This article presents details of the development, characterization and in vivo evaluations of powder metallurgy-processed titanium samples exhibiting a dense core with an integrated porous surface for biomedical applications. A space-holder method was applied to investigate the effects of different percentages and particle sizes of the urea on bone neoformation in 30 rabbits. The samples were previously characterized using scanning electron microscopy and mechanical testing. After 8 and 12 weeks of implantation, bone ingrowth was histologically and histometrically analyzed and push-out testing was performed. This study demonstrated that the association of a dense core integrated with the greatest number of interconnected pores of the smallest size is a promising biomaterial for bone tissue engineering. This sample exhibits appropriate mechanical properties combined with increased bone ingrowth, providing enhanced resistance to displacement.
Combining polyester scaffolds with synthetic nanohydroxyapatite (nHAp), which is bioactive and osteoconductive, is a plausible strategy to improve bone regeneration. Here, we propose the combination of PBAT [poly(butylene-adipate-co-terephthalate)] and synthetic nHAp (at 3 and 5wt%). PBAT is a relatively a new polymer with low crystallinity and attractive biodegradability and mechanical properties for orthopedic applications, however, with a still underexplored potential for in vivo applications. Then, we performed a careful biological in vitro and in vivo set of experiments to evaluate the influence of PBAT containing two different nHAp loads. For in vitro assays, osteoblast-like MG63 cells were used and the bioactivity and gene expression related to osteogenesis were evaluated by qRT-PCR. For in vivo experiments, twenty-four male rats were used and a tibial defect model was applied to insert the scaffolds. Micro-computed tomography (Micro-CT) and histological analysis were used to assess e bone neoformation after 6 weeks of implantation. Three point flexural tests measured the mechanical properties of the neoformed bone. All scaffolds showed promising in vitro properties, since they were not cytotoxic against MG-63 cells and promoted high cell proliferation and formation of mineralized nodules. From a mechanistic point-of-view, nHAp loading increased hydrophilicity, which in turn allowed for a better adsorption of proteins and consequent changes in the phenotypic expression of osteoblasts. nHAp induced better cellular responses on/in the scaffolds, which was mainly attributed to its osteoconductive and osteoinductive properties. Micro-CT images showed that nHAp at 3% and 5wt% led to more effective bone formation, presenting the highest bone volume after 6 weeks of implantation. Considering the three point flexural tests, 5wt% of nHAp positively influenced the flexural mode of the neoformed bone, but the stiffiness was similar between the 3% and 5wt% groups. In summary, this investigation demonstrated great potential for the application of these novel scaffolds towards bone regeneration and, thus, should be further studied.
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