Erste tierexperimentelle und klinische Erfahrungen mit bioaktiver Glaskeramik in der rekonstruktiven Mittelohrchirurgie

Reck, R

doi:10.1007/bf01109585

Cited by 23 publications

(7 citation statements)

References 3 publications

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“…The use of Ceravital TM for ossiculoplasty was reported first by Reck in the year 1979 [13]. Basically, glass ceramics show good biocompatibility, however, poor biostability: In vivo studies in rabbits [13,14] revealed a new layer of bone covered by mucosa on Ceravital TM -implants in the middle ear measuring up to 40 lm. The process of bone formation stops after four months following implantation.…”

Section: Glass Ceramicmentioning

confidence: 97%

Biomaterials for ossicular chain reconstruction. A review

Neumann

Jahnke

2003

Materialwissenschaft Werkst

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This review gives a survey of biomaterials used for ossicular chain reconstruction. The survey is focussed on application, biophysical requirements, properties and goals for future developments. The implantation site middle ear differs from others due to aeration and potential bacterial colonization. As a consequence, implant materials must exhibit excellent biocompatibility, biostabilty and sound conducting properties. In vitro and in vivo biocompatibility investigations and clinical observations determine the choice of material. Additionally the implants must provide the possibilty of intraoperative shaping or should be available in different variations in order to allow reconstruction appropriate to the individual conditions. Ceramics, metals and plastics are materials in current use. Based on thorough experimental and long term clinical experiences, the bioinert aluminum oxide is favorable amoung the ceramics. Bioactive ceramics may have minor biostability and the risk of fixation to surrounding bone which impairs sound conduction. This is also true for hydroxyapatite although biodegradation occurs only rarely. Today, titanium is the metal best established in middle ear implantation, reflected by excellent biocompatibility in vitro and in vivo, and good clinical results. Titanium is preferred by many surgeons, considering that sound transmission properties are mainly dependent on the implant weight. In stapes surgery, when the implant has direct contact to inner fluids, gold was accused to cause granuloma formation with subsequent inner ear damage in selected cases. In frequent past and present use, plastics (porous polyethylene and teflon) have proven to be of limited value in ossicular chain replacement because of high extrusion rates and the observation of material desintegration and bacterial colonization. In order to individually manage the pathological conditions in the middle ear, the implant design is of crucial importance. It is dependent on the ossicle to be replaced and the implant material. Future investigations have to minimize implant extrusions possibly by modifying and improving implant surfaces.

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Section: Glass Ceramicmentioning

confidence: 97%

Biomaterials for ossicular chain reconstruction. A review

Neumann

Jahnke

2003

Materialwissenschaft Werkst

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“…Verknöcherungen mit der Umgebung wurden häufig beschrieben und ließen dieses Material langfristig als ungeeig-net erscheinen [105]. Ceravital wurde nach dem tierexperimentellen Nachweis einer reizlosen Einheilung 1979 in die klinische Otologie eingeführt [106]. Es kann sich jedoch im entzündeten Mittelohr vollständig auflösen [107].…”

Section: Bioaktive Materialienunclassified

Passive und aktive Mittelohrimplantate

Beutner

Hüttenbrink

2009

Laryngo-Rhino-Otol

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Besides eradication of chronic middle ear disease, the reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The material of choice in cases of partial ossicular replacement prosthesis is the autogenous ossicle. In the event of more extensive destruction of the ossicular chain diverse alloplastic materials, e. g. metals, ceramics, plastics or composits are used for total reconstruction. Their specialised role in conducting sound energy within a half-open implant bed sets high demands on the biocompatibility as well as the acoustic-mechanic properties of the prosthesis. Recently, sophisticated titanium middle ear implants allowing individual adaptation to anatomical variations are widely used for this procedure. However, despite modern developments, hearing restoration with passive implants often faces its limitations due to tubal-middle-ear dysfunction. Here, implantable hearing aids, successfully used in cases of sensorineural hearing loss, offer a promising alternative. This article reviews the actual state of affairs of passive and active middle ear implants.

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“…Schepers, M. De Clercq and P. Ducheyne The basic hypothesis of the present study is that when such a bone apposition can be transformed into an effective bond between the implant and the bone tissue this favourable prognosis will be enhanced. Bioactive glass is a material able to bond with bone, but its limited mechanical properties render it incapable of bearing a functional load (Hench & Paschall, 1973, 1974Reck, 1979). Recently, it has also been shown that its mechanical behaviour can be substantially improved, by reinforcing it with a ductile second phase (Ducheyne & Hench, 1980, 1981Gheysen et al, 1983;Ducheyne, 1985).…”

Section: Introductionmentioning

confidence: 99%

Histological and histomorphometrical analysis of bioactive glass and fibre reinforced bioactive glass dental root implants

Schepers

Clercq

Ducheyne

1988

J of Oral Rehabilitation

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Bioactive glass has the ability to bond with bone, but it cannot be used as a load bearing device due to its limited mechanical properties. By reinforcing bioactive glass with a ductile second phase, a structurally reliable material is obtained. The aim of the present study was to evaluate histologically and morphometrically the interfacial behaviour of submerged composite dental root implants. Therefore, bulk and composite implants were subgingivally installed in the partially edentulous jaws of Beagle dogs and harvested after 4 and 16 months. Histologically, the connection between the implants and bone tissue could be clearly demonstrated. This bone connection is mainly located at the cortical bone level. In the vicinity of the infraalveolar nerve a fibrous tissue contact was found. It is shown that surgical trauma, motion at the glass to tissue interface, and gross ion dissolution from the material adversely affect the interfacial osteogenesis. If these factors are controlled, bone bonding is found over a larger area than the initial area of contact between the implant and bone tissue. This means that bone grows out along the implant surface, starting from the initial contact area. No difference was observed between the interfacial behaviour of bulk bioactive glass and intact fibre reinforced bioactive glass implants.

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Erste tierexperimentelle und klinische Erfahrungen mit bioaktiver Glaskeramik in der rekonstruktiven Mittelohrchirurgie

Cited by 23 publications

References 3 publications

Biomaterials for ossicular chain reconstruction. A review

Biomaterials for ossicular chain reconstruction. A review

Passive und aktive Mittelohrimplantate

Histological and histomorphometrical analysis of bioactive glass and fibre reinforced bioactive glass dental root implants

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