Comparison of a Hydroxyapatite-Coated and an Anodic Oxidized Titanium Implant for Experimentally Induced Peri-Implantitis: Macroscopic and Novel Radiographic Evaluations in a Canine Model

Nakamura, Hajime; Matsuno, Tomonori; Hashimoto, Yoshiya; Nakamura, Tatsuo; Mataga, Izumi

doi:10.2485/jhtb.24.347

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…Among the types of pin materials and coatings that have been assessed in published clinical studies, there are bioceramics and different metals (stainless steel and titanium), as well as coatings such as hydroxyapatite (HA), HA plus FGF-2 (factor of fibroblast growth 2), silver coating, and iodine coated systems [13][14][15]. Although HA coating is one of the most studied systems, the real impact towards the reduction of superficial and deep infectious complications still needs to be evaluated [16,17]. In fact, over the last 20 years, few comparative prospective clinical studies and only two systematic reviews have addressed the role of coated pins in the infection rate of the pin site in human clinical studies.…”

Section: Introductionmentioning

confidence: 99%

Hydroxyapatite-coated compared with stainless steel external fixation pins did not show impact in the rate of pin track infection: a multicenter prospective study

Stoffel

Lima

Salles

2023

International Orthopaedics (SICOT)

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Purpose Infection at the pin site remains the most common complication of external fixators (EFs). It is known that hydroxyapatite (HA)-coated pins increase bone adhesion and may lead to reduced rates of reported infections. The present study compares the rates of pin track infection associated with stainless steel and HA-coated pins. Methods This is a prospective, multicenter, nonrandomized, comparative intervention study among patients undergoing surgical treatment with EFs of any type between April 2018 and October 2021. Patients were followed up until the removal of the EF, or the end of the study period (ranging from 1 to 27.6 months). The definition of pin track infection was based upon the Maz-Oxford-Nuffield (MON) pin infection grading system. Results Overall, 132 patients undergoing external fixation surgery were included. Of these, 94 (71.2%) were male, with a mean age of 36.9 years (SD ± 18.9). Infection of any type (score > 1) was observed in 63 (47.7%) patients. Coated and uncoated-pin track-infection occurred in 45.7% and 48.5% of patients, respectively ( P = 0.0887). The probability of developing infection (defined as a score ≥ 2) adjusted for comorbidities and follow-up time was not statistically higher among those who received uncoated pins compared to those who received pins coated with HA (odds ratio (OR) = 1.56, 95% confidence interval (95% CI): 0.67–3.67, p <0.05). Conclusion In the present study, the external fixator pin infection rates were similar when using HA coating and standard steel pins. Supplementary Information The online version contains supplementary material available at 10.1007/s00264-023-05717-w.

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Section: Introductionmentioning

confidence: 99%

Hydroxyapatite-coated compared with stainless steel external fixation pins did not show impact in the rate of pin track infection: a multicenter prospective study

Stoffel

Lima

Salles

2023

International Orthopaedics (SICOT)

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“…A few types of pin materials have been assessed in previous published clinical studies, including ceramic and metallic (stainless steel and titanium), and also coatings such as hydroxyapatite (HA), HA plus fibroblast growth factor 2 (FGF-2), silver coating and iodine-coated systems[ 6 , 11 , 13 - 15 ]. Even though HA coating is one of the most studied coating systems, whether this and other products can effectively reduce the number of infections remains unclear[ 11 , 15 - 18 ]. Indeed, over the last 20 years, few prospective clinical studies and only two systematic reviews addressed the role of coated pins on the rate of pin site infection in human clinical studies.…”

Section: Introductionmentioning

confidence: 99%

Role of coatings and materials of external fixation pins on the rates of pin tract infection: A systematic review and meta-analysis

Stoffel¹,

Eltz²,

Salles³

2021

WJO

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BACKGROUND Infection at the pin tract is a frequent and feared complication of external fixators (EF). The type of pin material and coatings have been regarded as possibly influencing infection rates. Over the last 20 years, few prospective clinical studies and systematic reviews addressed the role of coated pins on the rate of pin site infection in human clinical studies. AIM To assess the EF literature over the past 20 years on the clinical benefits of pins manufactured from varied materials and coating systems and their possible role in pin tract infection rates. METHODS We performed a systematic review according to the PRISMA and PICOS guidelines using four scientific platforms: PubMed, LiLacs, SciELO, and Cochrane. We searched the literature for related publications over the past 20 years. RESULTS A literature search yielded 29 articles, among which seven met the inclusion criteria. These studies compared stainless-steel pins and pins coated with hydroxyapatite (HA), titanium and silver. The pin tract infection definitions were arbitrary and not standardized among studies. Most studies included a low number of patients in the analysis and used a short follow-up time. Three meta-analyses were carried out, comparing stainless steel vs silver pins, stainless steel vs HA-coated pins, and titanium vs HA-coated pins. None of this analysis resulted in statistically significant differences in pin tract infection rates. CONCLUSION Currently, no clinical evidence supports the advantage of EF pins manufactured with materials other than stainless steel or coated over uncoated pins in reducing the rates of pin tract infections. A standardized definition of pin tract infection in external fixation is still lacking.

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“…4 Although HA is a biocompatible and an osteoconductive material, a plasma-sprayed thick and porous HA coating is more susceptible to infection in animal studies than a thin HA coating or noncoating when they are contaminated with bacteria or implanted percutaneously. 5 Coatings of fibroblast growth factor 2 (FGF-2)-apatite composite have led to increased bone-screw interface strength and reduced infection rates in screw tracts in animal studies. An FGF-2-apatite composite layer was formed on the surface of titanium implants using the coprecipitation method.…”

Section: Introductionmentioning

confidence: 99%

Initial clinical trial of pins coated with fibroblast growth factor-2–apatite composite layer in external fixation of distal radius fractures

Yanagisawa

Ito

Hara

et al. 2019

Journal of Orthopaedics

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Background: Pin tract infection and loosening are major complications and challenges in the treatment of fractures by external fixation. To address this issue, we developed titanium pins coated with a fibroblast growth factor 2 (FGF-2)-apatite composite layer. The purpose of this initial clinical trial is to clarify the safety and feasibility of using these pins for the external fixation of distal radius fractures. Methods: Unstable, displaced fractures of the distal radius that were medically suitable for external fixation were treated using external fixation pins coated and uncoated with an FGF-2-apatite composite layer. The coated pin group (n = 5) comprised 5 women (average age, 70.4 ± 5.9 years), whereas the uncoated pin group (n = 10) comprised 8 women and 2 men (average age, 64.4 ± 11.7 years). The average duration of external fixation was 40.8 ± 1.3 and 41.6 ± 2.1 days for the coated and uncoated pin groups, respectively. Results: All patients achieved fracture union. One patient in the uncoated group had severe pin tract infection on the day of pin extraction. No pin loosening or difficulty in pin removal was observed in either group. Bacterial growth was present in 5% and 25% of the pin sites in the coated and uncoated groups, respectively (p = 0.059). No adverse events such as tumor formation were observed for more than 2 years after surgery in the coated pin group. Conclusions: This study clarified the safety and feasibility of using pins coated with an FGF-2-apatite composite layer for the external fixation of distal radius fractures.

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Comparison of a Hydroxyapatite-Coated and an Anodic Oxidized Titanium Implant for Experimentally Induced Peri-Implantitis: Macroscopic and Novel Radiographic Evaluations in a Canine Model

Cited by 3 publications

References 26 publications

Hydroxyapatite-coated compared with stainless steel external fixation pins did not show impact in the rate of pin track infection: a multicenter prospective study

Hydroxyapatite-coated compared with stainless steel external fixation pins did not show impact in the rate of pin track infection: a multicenter prospective study

Role of coatings and materials of external fixation pins on the rates of pin tract infection: A systematic review and meta-analysis

Initial clinical trial of pins coated with fibroblast growth factor-2–apatite composite layer in external fixation of distal radius fractures

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