Tissue reactions to glass ceramics in the middle ear

Reck, R

doi:10.1111/j.1365-2273.1981.tb01786.x

Cited by 53 publications

(19 citation statements)

References 2 publications

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“…The bioglass Ceravital is a bioactive calcium-silicon ceramic and is known to biodegrade, particularly in the infected middle ear, showing giant cells in the fibrous tissue surrounding the biomaterial [32]. This has resulted in a major loss of mechanical stability [33,34].…”

Section: Discussionmentioning

confidence: 99%

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit

Schwager

1998

European Archives of Oto-Rhino-Laryngology

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The middle ear poses unique challenges when finding suitable materials for ossicular reconstruction, primarily because of its link to the external environment via the eustachian tube and, hence, its greater exposure to infectious agents. In this study, the biocompatability of titanium was examined in the middle ear of rabbits by using light and scanning electron microscopy. Implants were placed as middle ear prostheses or as free implants. These were inspected at 28 days, 84 days, 168 days, 336 days and 504 days following implantation for mucosal coverage, percent epithelization and any sign of foreign-body reaction. After 28 days, the prostheses were covered by regular mucosa. Although a majority of the free implants took up to 336 days for complete epithelialization, some of the free implants were not epithelialized even at day 504. There were no inflammatory cells observed on the surface of the material, nor were unusual amounts of fibrous tissue seen. In addition, the titanium material exhibited an affinity toward bone. The results of this animal experiment indicate that titanium is a favorable material for ossicular replacement prostheses.

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Section: Discussionmentioning

confidence: 99%

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit

Schwager

1998

European Archives of Oto-Rhino-Laryngology

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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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“…The first reports on clinical applications of bioactive glass emerge in the 1980s [145]. Since then, bioactive glass has been applied for craniofacial reconstructive surgery, dental surgery and trauma or orthopedic surgery.…”

Section: Clinical Indicationsmentioning

confidence: 99%

Bone substitutes in the Netherlands – A systematic literature review

Stok¹,

Lieshout²,

El-Massoudi³

et al. 2011

Acta Biomaterialia

212

130

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Autologous bone grafting is currently considered as the gold standard to restore bone defects. However, clinical benefit is not guaranteed and there is an associated 8-39% complication rate. This has resulted in the development of alternative (synthetic) bone substitutes. The aim of this systematic literature review was to provide a comprehensive overview of literature data of bone substitutes registered in the Netherlands for use in trauma and orthopedic surgery. Brand names of selected products were used as search terms in three available databases: Embase, PubMed and Cochrane. Manuscripts written in English, German or Dutch that reported on structural, biological or biomechanical properties of the pure product or on its use in trauma and orthopedic surgery were included. The primary search resulted in 475 manuscripts from PubMed, 653 from Embase and 10 from Cochrane. Of these, 218 met the final inclusion criteria. Of each product, structural, biological and biomechanical characteristics as well as their clinical indications in trauma and orthopedic surgery are provided. All included products possess osteoconductive properties but differ in resorption time and biomechanical properties. They have been used for a wide range of clinical applications; however, the overall level of clinical evidence is low. The requirements of an optimal bone substitute are related to the size and location of the defect. Calcium phosphate grafts have been used for most trauma and orthopedic surgery procedures. Calcium sulphates were mainly used to restore bone defects after tumour resection surgery but offer minimal structural support. Bioactive glass remains a potential alternative; however, its use has only been studied to a limited extent.

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Tissue reactions to glass ceramics in the middle ear

Cited by 53 publications

References 2 publications

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit

Titanium as a biomaterial for ossicular replacement: results after implantation in the middle ear of the rabbit

Biomaterials for ossicular chain reconstruction. A review

Bone substitutes in the Netherlands – A systematic literature review

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