Infection in orthopaedic and trauma surgery remains a destructive complication with particularly challenging diagnosis and treatment due to bacterial antibiotic resistance and biofilm formation. Along with surgical debridement and systemic antibiotics, an important type of adjuvant therapy is local antibiotic delivery, with the purpose of eliminating bacterial colonization and biofilm development. Calcium sulphate, as a synthetic absorbable biomaterial used for local antibiotic delivery, has experienced an increasing popularity during the last decade, with multiple promoted advantages such as predictable antibiotic elution kinetics, complete and quick biodegradation, good biocompatibility, and limited associated complications. A series of commercially available antibiotic-delivery systems based on calcium sulphate are under investigation and in clinical use, with different presentations, compositions, and application techniques. The current article presents the main available calcium-sulphate-based products and the existing data about the clinical and preclinical research results, stemming from their implementation as local antibiotic carriers for surgical site and implant-associated infections treatment and prevention. Cite this article: EFORT Open Rev 2021;6:297-304. DOI: 10.1302/2058-5241.6.200083

Failure of osteosynthesis implants is an intricate matter with challenging management that calls for efficient investigation and prevention. Using implant retrieval analysis combined with standard radiological examination, we evaluated the main causes for osteosynthesis implant breakdown and the relations among them for a series of cases. Twenty-one patients diagnosed with implant failure were assessed for this work. For metallurgical analysis, microscopy techniques such as scanning electron microscopy (SEM), stereomicroscopy, and optical microscopy were employed. The results showed that material structural deficiencies (nine patients) and faulty surgical techniques (eight patients) were the main causes for failure. An important number of patients presented with material structural deficiencies superimposed on an imperfect osteosynthesis technique (six patients). Consequently, the importance of failure retrieval analysis should not be overlooked, and in combination with other investigational techniques, must provide information for both implant manufacturing and design improvement, as well as osteosynthesis technique optimization.

Among esthetic procedures, teeth whitening is a common and often used treatment for patients who seek good teeth appearance. We developed an experimental green tea extract and an experimental green tea gel for enamel restoring treatment after bleaching. We also tested the antibacterial and antifungal effect of the experimental extract against specific endodontic and cariogenic microorganisms. The green tea extract antibacterial action was determined by the disk-diffusion method using Peptostreptococcus anaerobius (ATCC27337), Corynebacterium xerosis (ATCC 373), Streptococcus mutans (ATCC 25175) and Candida albicans (ATCC 10231) strains. Enamel microstructure was investigated by SEM analysis, and surface details were revealed by AFM. The inhibition zones around the wells showed evident antimicrobial activity of the experimental extract. In the presence of Candida albicans (ATCC 10231), the extract showed no antifungal activity. The enamel’s surface roughness and hydroxyapatite prism aspects were the parameters followed throughout the study. The experimental green tea extract is efficient against some microorganisms commonly found in the oral cavity. However, the studied extract had no antifungal effect. The results show that after bleaching with the experimental gel, we obtained the best surface parameters, similar to healthy enamel.