Direct current influence on bone formation in titanium implants

Buch, F.; Albrektsson, Tomas; Herbst, E.

doi:10.1016/0142-9612(84)90032-2

Cited by 32 publications

(16 citation statements)

References 14 publications

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“…Endogenous electric fields also play a similarly important role in bone growth and repair (Fukada and Yasuda, 1957; Konikoff, 1975; McDonald, 1993). Constant current electric stimulation can reliably induce ossification at the cathode, particularly in conjunction with the placement of tissue engineering scaffolds (O'Connor et al, 1969; Buch et al, 1984; Kuzyk and Schemitsch, 2009; Victoria et al, 2009; Griffin and Bayat, 2011; Leppik et al, 2018). DC electric fields are thought to influence ossification primarily via local electrochemical/pH changes at the electrode interface (Brighton et al, 1975; Griffin and Bayat, 2011).…”

Section: Tissue Effects Of Sustained Electric Fieldsmentioning

confidence: 99%

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Aplin

Fridman

2019

Front. Neurosci.

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Implantable neuroprostheses such as cochlear implants, deep brain stimulators, spinal cord stimulators, and retinal implants use charge-balanced alternating current (AC) pulses to recover delivered charge and thus mitigate toxicity from electrochemical reactions occurring at the metal-tissue interface. At low pulse rates, these short duration pulses have the effect of evoking spikes in neural tissue in a phase-locked fashion. When the therapeutic goal is to suppress neural activity, implants typically work indirectly by delivering excitation to populations of neurons that then inhibit the target neurons, or by delivering very high pulse rates that suffer from a number of undesirable side effects. Direct current (DC) neural modulation is an alternative methodology that can directly modulate extracellular membrane potential. This neuromodulation paradigm can excite or inhibit neurons in a graded fashion while maintaining their stochastic firing patterns. DC can also sensitize or desensitize neurons to input. When applied to a population of neurons, DC can modulate synaptic connectivity. Because DC delivered to metal electrodes inherently violates safe charge injection criteria, its use has not been explored for practical applicability of DC-based neural implants. Recently, several new technologies and strategies have been proposed that address this safety criteria and deliver ionic-based direct current (iDC). This, along with the increased understanding of the mechanisms behind the transcutaneous DC-based modulation of neural targets, has caused a resurgence of interest in the interaction between iDC and neural tissue both in the central and the peripheral nervous system. In this review we assess the feasibility of in-vivo iDC delivery as a form of neural modulation. We present the current understanding of DC/neural interaction. We explore the different design methodologies and technologies that attempt to safely deliver iDC to neural tissue and assess the scope of application for direct current modulation as a form of neuroprosthetic treatment in disease. Finally, we examine the safety implications of long duration iDC delivery. We conclude that DC-based neural implants are a promising new modulation technology that could benefit from further chronic safety assessments and a better understanding of the basic biological and biophysical mechanisms that underpin DC-mediated neural modulation.

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Section: Tissue Effects Of Sustained Electric Fieldsmentioning

confidence: 99%

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Aplin

Fridman

2019

Front. Neurosci.

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“…The present PEMF physical parameters were chosen because of the good results they had ensured in other authors' studies on bone healing [5][6][7][8][9]26,42], and in previous in vitro studies on different cell types-also from osteopenic bone -always performed by the current authors [40,41]. Treatment time is consistent with the current opinion that a daily application of 6 h is adequate and that longer treatment times do not ensure a proportional increase in therapeutic effect [42].…”

Section: Discussionmentioning

confidence: 99%

“…Disregarding the biomaterial improvement, bone spontaneous endogenous repair may be stimulated with adjuvant treatments to be associated with standard surgical procedures, thus contributing to accelerate bone ingrowth and strengthen the boneimplant interface [34]. Many biophysical stimuli were tested and seemed to positively influence the bonematerial interface [6,11,18,19,33,38,43,44]. Regarding Pulsed Electromagnetic Fields (PEMFs), some positive clinical results on post-implantation pain reduction and function recovery after total hip replacement were also reported [22].…”

Section: Introductionmentioning

confidence: 99%

The effect of pulsed electromagnetic fields on the osteointegration of hydroxyapatite implants in cancellous bone: a morphologic and microstructural in vivo study

Fini

Cadossi

Canè

et al. 2002

Journal Orthopaedic Research

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Effects of pulsed electromagnetic fields (PEMFs, 75 Hz, 1.6 mT) were investigated in 12 rabbits after placing hydroxyapatite (HA) implants in their femoral condyles. Six animals were stimulated with PEMFs for three consecutive weeks, 6 h/day, while the remaining animals were sham-treated (Control Group). Rabbits were sacrificed at 3 and 6 weeks (after a 3-week non-stimulation period) for histomorphometric analysis and microhardness testing (at 200, 500, 1000, 2000 pm from the implant) around the implants. Histomorphometric analysis did not highlight any significant changes. On the contrary, there were statistically significant differences between the effects produced by PEMFs and Control Groups ( F = 149.70, p < 0.0005) on the Affinity Index results, as well as by the experimental time of 6 and 3 weeks ( F = 17.12, p = 0.001) on the same results. In PEMF-stimulated animals the microhardness (HV) values measured in trabecular bone at a distance of 200 and 500 pm from the implants, were significaiitly higher with respect to controls. At 6 weeks, HV values at the bone-implant interface in PEMF-stimulated animals were not significantly different with respect to normal bone, while they remained significantly lower in control animals. Both morphological and structural results demonstrated a positive therapeutic effect of PEMFs in accelerating HA osteointegration in trabecular bone.

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“…Three modalities of electrical stimulation have commonly been used for this purpose: (i) direct stimulation, (ii) indirect stimulation (capacitive or inductive couplings), and (iii) combined stimulation 20 . Studies reveal significant increases in bone-implant contact 4,9,[21][22][23] , differentiation of preosteoblasts 12,24 , and increased cell proliferation 25 upon application of direct current (DC) stimulation. However, DC stimulation can include pH shifts, accumulation of oppositely charged proteins at the implant surface, and production of reactive oxygen species in the adjacent environment 25 .…”

mentioning

confidence: 99%

Enhancing osteoblast survival through pulsed electrical stimulation and implications for osseointegration

Pettersen

Shah

Ortiz-Catalán

2021

Sci Rep

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Electrical stimulation has been suggested as a means for promoting the direct structural and functional bonding of bone tissue to an artificial implant, known as osseointegration. Previous work has investigated the impact of electrical stimulation in different models, both in vitro and in vivo, using various electrode configurations for inducing an electric field with a wide range of stimulation parameters. However, there is no consensus on optimal electrode configuration nor stimulation parameters. Here, we investigated a novel approach of delivering electrical stimulation to a titanium implant using parameters clinically tested in a different application, namely peripheral nerve stimulation. We propose an in vitro model comprising of Ti6Al4V implants precultured with MC3T3-E1 preosteoblasts, stimulated for 72 h at two different pulse amplitudes (10 µA and 20 µA) and at two different frequencies (50 Hz and 100 Hz). We found that asymmetric charge-balanced pulsed electrical stimulation improved cell survival and collagen production in a dose-dependent manner. Our findings suggest that pulsed electrical stimulation with characteristics similar to peripheral nerve stimulation has the potential to improve cell survival and may provide a promising approach to improve peri-implant bone healing, particularly to neuromusculoskeletal interfaces in which implanted electrodes are readily available.

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Direct current influence on bone formation in titanium implants

Cited by 32 publications

References 14 publications

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

The effect of pulsed electromagnetic fields on the osteointegration of hydroxyapatite implants in cancellous bone: a morphologic and microstructural in vivo study

Enhancing osteoblast survival through pulsed electrical stimulation and implications for osseointegration

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