Successful Implant Research Articles

Breaking the Limit of Cardiovascular Regenerative Medicine: Successful 6-Month Goat Implant in World's First Ascending Aortic Replacement Using Biotube Blood Vessels.

This study investigated six-month outcomes of first models of ascending aortic replacement. The molds used to produce the Biotube were implanted subcutaneously in goats. After 2-3 months, the molds were explanted to obtain the Biotubes (inner diameter, 12 mm; wall thickness, 1.5 mm). Next, we performed ascending aortic replacement using the Biotube in five allogenic goats. At 6 months, the animals underwent computed tomography (CT) and histologic evaluation. As a comparison, we performed similar surgeries using glutaraldehyde-fixed autologous pericardial rolls or pig-derived heterogenous Biotubes. At 6 months, CT revealed no aneurysmalization of the Biotube or pseudoaneurysm formation. The histologic evaluation showed development of endothelial cells, smooth muscle cells, and elastic fibers along the Biotube. In the autologous pericardium group, there was no evidence of new cell development, but there was calcification. The histologic changes observed in the heterologous Biotube group were similar to those in the allogenic Biotube group. However, there was inflammatory cell infiltration in some heterologous Biotubes. Based on the above, we could successfully create the world's first Biotube-based ascending aortic replacement models. The present results indicate that the Biotube may serve as a scaffold for aortic tissue regeneration.

(800) - Successful Left Ventricle Assist Device Implant in a Patient with Acute Heart Failure with Biventricular Dysfunction

(800) - Successful Left Ventricle Assist Device Implant in a Patient with Acute Heart Failure with Biventricular Dysfunction

Involvement of interlukin-17A (IL-17A) gene polymorphism and interlukin-23 (IL-23) level in the development of peri-implantitis

BackgroundDental implantation has been practiced since ancient times and has gone through several stages. Dentists use dental implants to support dental prostheses such as crowns, bridges, dentures, face prostheses, or as an orthodontic anchor. Thus, the purpose of this study is to detect the role of the immune-genetic variation of IL-17A and related inflammatory cytokine (IL-23) in the initiation and progress of peri implantitis.Material and methodsThis cross-sectional study included 80 subjects (15 peri-implantitis patients, 35 successful implants, and 30 healthy controls); their mean age was (43.91 ± 11.33) years. Blood samples and Peri-implant sulcus fluid (PISF) were collected from all subjects (patients with peri-implantitis, successful implants, and healthy controls) attending the Department of Oral and Maxillofacial Surgery in the Dental College Teaching Hospital, Baghdad University, Baghdad, Iraq. The blood sample detects gene polymorphisms in interleukin-17A by a polymerase chain reaction (PCR). An enzyme-linked immunosorbent assay (ELISA) was carried out to estimate the Peri-implant sulcus fluid (PISF) levels of interleukin-23.ResultThe current study revealed an obvious significant elevation in the mean level of interleukin-23 in the peri-implantitis patient’s group more than its level in the successful implant and control groups (P < 0.05). In addition, the result showed that A/A genotype is associated significantly with peri-implantitis OR (95%confidence interval) =6.9 (1.7121 to 27.4638) folds increase risk of peri-implantitis) (p = 0.0065), while G/A genotype had OR 4.9 (0.9539–24.9394) folds increased risk of peri-implantitis, (p = 0.0572). But it was not statistically significant and G/G genotype had a one-fold increase risk of peri-implantitis.ConclusionThe increased level of inflammatory cytokine (interleukin-23) might add to the systemic inflammatory burden a predisposing factor, which may lead to impaired osseointegration and subsequent bone loss or implant failure. In addition, IL-17A gene polymorphism may play a role in peri-implant disease susceptibility, especially in persons carrying the rs2275913 A allele at a higher risk of developing peri-implantitits as compared with those carrying the G allele.

Socket Preservation and Guided Bone Regeneration: Prerequisites for Successful Implant Dentistry

Socket Preservation and Guided Bone Regeneration: Prerequisites for Successful Implant Dentistry

Outcomes After Successful Debridement, Antibiotic, and Implant Retention Therapy for Periprosthetic Joint Infection in Total Knee Arthroplasty

BackgroundControversy surrounds debridement, antibiotic and implant retention (DAIR) for treatment of acute periprosthetic joint infection (PJI). Data regarding DAIR’s rate of infection resolution is variable with little investigation of functional outcomes. MethodsWe identified 191 DAIR cases at a single institution from 2008 to 2020. Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and Patient Reported Outcome Measurement Information System-10 (PROMIS) scores were collected. Patient Reported Outcome Scores were obtained from 60 cases. Median follow-up (IQR) was 4.5 (2.1 to 7.6) versus 3.0 (1.2 to 5.3) years for the control group. Mean scores were compared to a cohort of uncomplicated total knee arthroplasties matched by age, body mass index, and sex using generalized linear models adjusted for follow-up duration. Kaplan-Meier survivorship curves for PJI were constructed. ResultsMean Patient Reported Outcome Scores for the DAIR cohort were 57.2 ± 19.7 for KOOS-JR, 41.6 ± 7.1 for PROMIS physical health (PH), and 46.6 ± 8.7 for PROMIS mental health (MH). Mean control group values were 65.8 ± 21.0 for KOOS-JR, 44.6 ± 8.4 for PROMIS PH, and 49.2 ± 9.2 for PROMIS MH. No difference was observed in KOOS-JR (P = .83) or PROMIS MH (P = .11). PROMIS PH was lower in the DAIR cohort compared to the control group (P = .048). Median follow-up (years) for all 191 cases was 5.9 (range, 0.5 to 13.1). Survivorship (years) without subsequent operation for infection was 84% at 1, 82% at 2, and 79% at 5. ConclusionKnee and MH outcomes in successful DAIR procedures were similar to uncomplicated total knee arthroplasty. DAIR’s success rate was 79% in treating acute PJI at 5 years. Level of EvidenceLevel III.

3Cs of Successful Implant Prosthesis: Connections, Contours, and Contacts

3Cs of Successful Implant Prosthesis: Connections, Contours, and Contacts

Complex Therapeutic Process due to Diagnostic Error in the Periapical Fibro-Osseous Lesion of Mandibular First Molar. A Case Report with Successful Implant Placement

Complex Therapeutic Process due to Diagnostic Error in the Periapical Fibro-Osseous Lesion of Mandibular First Molar. A Case Report with Successful Implant Placement

Successful New Dental Implant Installation in aHealed Site of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Case Report.

The purpose of this case report was to present a rare clinical case of successful new dental implant installation in the site of previously healed medication-related osteonecrosis of the jaw (MRONJ). An 80-year-old female patient with history of oral bisphosphonate (BP) therapy presented with pain and swelling of gingiva in the right posterior mandible. One of the three implants placed 15 years ago in the right mandibular posterior area was removed 6 months before the visit to our hospital, which led to worsening of the symptoms. After clinical and radiographic examination, the patient was diagnosed with stage 2 MRONJ. Along with antibiotic therapy, the patient underwent surgical intervention via sequestrectomy and removal of the remaining two implants. Adequate soft and hard tissue healing without any complications and signs of recurrence was confirmed, and implant installation with simultaneous bone grafting and prosthesis fabrication were done in the explantation sites of MRONJ. By the 7-year follow-up, no implant failure has been observed, and installation of implants was successful in the previously healed MRONJ site. Dental implant installation is possible in a patient with history of failed implant due to MRONJ. However, a careful treatment planning is needed before implantation in a previously healed site of MRONJ to reduce the potential risks of MRONJ recurrence and implant failure.

Ridge Augmentation Is a Prerequisite for Successful Implant Placement: A Literature Review.

Alveolar ridge defects are commonly seen in partially dentate patients, and they jeopardize speech, appearance, and oral hygiene maintenance. These defects affect both soft tissues and bone and are mainly caused by trauma. These defects are more prevalent in middle-aged male patients and it is imperative that the defective ridge is augmented before receiving an implant or a fixed partial denture. This review focuses on the different types of ridge defects and their treatment options.

Successful Implant Placement into a Site with Two Previous Failures: A Clinical and Histologic Case Report.

Implants present a predictable fixed option for patients who require tooth extraction. However, complications such as implant failure reduce the success of replacement implant restorations. A patient presented to the Department of Periodontology and Implant Dentistry (New York University College of Dentistry) with pain related to a broken implant-supported prosthesis. Two failed implants were removed, and new implants were placed. After restoration delivery, the patient reported soreness on the implant at site 35 (FDI tooth-numbering system), which was then removed (along with a sequestrum of bone) and sent for biopsy. A new implant was placed and restored successfully at the 1-year follow-up. The purpose of this case report is to demonstrate that with proper planning, surgery, and restoration, a new implant can be successfully placed and restored on a site with two previous failures. Int J Periodontics Restorative Dent 2023;43:167-172. doi: 10.11607/prd.5410.

Prerequisite for Successful Implant Placement with a Comparative Study on Novel Bone Ring Technique: A Review

Implant placement is getting space day by day. However, in every case, we never get the ideal condition of alveolar bone for implant placement. Alveolar bone loss is seen due to periodontitis, tooth loss, tooth extraction, and periapical infection, etc.&#x0D; Resorption of alveolar bone varies from person to person and side to side. It has been noted that the size of the residual ridge shrinks more quickly within the first six months.&#x0D; There is new demand for reconstruction of the alveolar ridge for implant placement. Various techniques are available for increasing the ridge height and width by using bone graft, membrane, etc., one of these is the vertical ring procedure.&#x0D; Bone ring technique (BRT) has been described as a one-stage approach to restore vertical ridge height defects, in which an autogenous or allogeneic bone block graft is used and the implant is placed simultaneously.&#x0D; This review aims to focus on the importance of the implant placement, consequences of complete edentulism, the problem with removable partial denture (RPD) placement, as a result of bone loss in fully edentulism patients, and the use of vertical ring technique for the implant placement.

Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments.

After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.

Early failure of a polyvinyl alcohol hydrogel implant with foreign body reaction and osteolysis in an ovine model of cartilage repair

Purpose: Hemiarthroplasty with polyvinyl alcohol hydrogel (PVA) cartilage implants in the treatment of hallux rigidus showed initial promise with a 90% success rate. However, recent studies suggest that the implant may shrink and subside, leading to higher than anticipated failure rates. The purpose of this study was to characterize the healing response to polyvinyl implantation by using an ovine model. Methods: An osteochondral defect was created unilaterally in the medial femoral condyle of six sheep and filled with a PVA implant (Cartiva, Wright Medical) (n=4) or left empty (n=2). Sheep were followed for six months. Post-mortem quantitative CT (qCT) evaluations were performed to measure bone density using 5mm-wide ROI delineated in 3D reconstruction around the defect/implant area. Joints were then dissected and evaluated using a modified International Cartilage Repair Society (ICRS) macroscopic score (I=best, IV=worst). Osteochondral sections were assessed using a modified Osteoarthritis Research Society International (OARSI) histopathology net score (0=best, 20=worst). Synovial membrane histology was scored using the aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) scoring system for soft tissue reaction (0=best, 19=worst). Both the synovial membrane and osteochondral sections underwent immunohistochemistry with anti-ionized calcium-binding adapter molecule 1 antibody (Iba1) to identify macrophages. Results: Two of four sheep with the PVA implant showed unrelenting pain and lameness necessitating early euthanasia. These were considered failed implants. qCT scans revealed 2-fold more osteolysis around failed implants than the other two (successful) implants or empty defects (Figure 1A). Grossly, failed implant sheep had ICRS scores of III and IV/V. The two successful implant sheep had ICRS scores of II/V and both empty defect sheep had scores of III/V. Osteochondral histology of failed implants had a mean OARSI score of 13/20 with extensive GAG loss and a stromal inflammatory reaction surrounding the implant that was up to 5-fold wider than successful implants (Figure 1B). This reaction contained abundant fibrovascular tissue with aggregates of lymphocytes and plasma cells. Failed implants revealed strong and diffuse Iba1 staining of macrophages along the implant/bone interface with cells densely packed in multiple rows (Figure 1C). Multinucleated giant cells and macrophages were identified surrounding presumptive implant debris in one failed implant (Figure 1C, red arrow and X). Successful implants and empty defects had few Iba1 positive cells randomly distributed (Figure 1C). Mean synovial membrane ALVAL score for failed implants was 11/19 with presence of an adverse local tissue reaction with lymphocytes and macrophages, vascular reactivity, and synovial hyperplasia (Figure 1D, E). In contrast, synovial membrane in successful implants and empty defects were normal (ALVAL 0/19). Conclusions: Polyvinyl alcohol hydrogel implants had a 50% early failure rate with uncontrollable pain, severe osteolysis, inflammation and an adverse local tissue reaction. Furthermore, the recruitment of macrophages and multinucleated giant cells are evidence of a foreign body reaction typically associated with implant wear debris. Non-degradable biomaterials such as PVA will result in continuous infiltration by macrophages and secretion of proinflammatory cytokines, leading to periprosthetic osteolysis and ultimately implant failure. These Results suggest that the use of this PVA implant should not be continued in human patients without further in vivo safety studies.

Maxillary Alveolar Bone Dimensional Changes of Post -Extraction Sockets in Humans

Dentistry has remarkable advancements in dental restorative materials, techniques and strategies that are remarkable in many ways. Scientifically proven approaches have proved that implants were esthetically and functionally excellent options for tooth replacement. Restoration of dental implant is considered to be a highly evolved procedure for oral health care considering reserved specialists and requires training beyond the regular dental school curriculum. Considering these important facts, a thorough knowledge of maxillary sinus anatomy in the edentulous patient is very much required for placement of successful maxillary sinus implants and the changes occurring in it periodically due course with no replacement. Treatment planning is very crucial considering the events occurring in dimensional changes in the maxillary sinus for successful implant placements and prognosis. The current study focuses on physical and physiological events occurring in the maxillary sinus due to a lack of prosthesis.

Abstract 15655: Safety and Efficacy of Subclavian Fibroplasty in Patients With Prior Left Ventricular Lead Implant Failure

Introduction: Fibrous subclavian vein obstruction (SVO) is a common primary cause of left ventricular (LV) lead implant failure. Such obstruction might be apparent or unrecognized. Balloon dilation of the aggressive fibrosis that develops in response to chronic leads (fibroplasty) can be employed safely to achieve a successful implant. Hypothesis: To describe the experience of high-volume referral center with balloon dilation of fibrous tissue in patients with prior LV lead implant failure. Methods: We evaluated the role of balloon dilation in 187 patients referred to our institute because of prior LV lead implant failure between June 2017 and November 2019. Results: Of the 187 patients, 35 (19%) had apparent SVO as the primary explanation for implant failure. In 152 (81%), SVO was not recognized as contributing to implant failure. In 32 of 35 with apparent SVO (91.4%), it was possible to cross the obstruction and perform fibroplasty successfully. Three cases (8.6%) failed due to inability to advance a wire through the obstruction, none had existing leads to follow. In 33 of 152 (22%) cases without recognized SVO, fibroplasty of the subclavian was required, in addition to another interventional techniques, for successful implantation. There were no major or minor vascular complications related to fibroplasty. There was no distal embolization and no damage to the existing leads. Conclusions: In the setting of chronic leads, apparent SVO is commonly recognized as a cause of LV lead implant failure. However, 22% of prior LV lead implant failures without obvious obstruction also required fibroplasty (in addition to another interventional techniques) for success. In conclusion, subclavian fibroplasty is essential for successful implantation in patients with prior LV lead implant failure with and without obvious obstruction and can be safely performed by the implanting physician.

Previously successful dental implants can fail when patients commence anti-resorptive therapy—a case series

This article reports a type of localized osteonecrosis that can occur in patients who have had successful osseointegrated implants for many years and then commence anti-resorptive therapy. Eleven female patients were identified who had successful implant insertion, but who were placed on anti-resorptive therapy (bisphosphonates or denosumab) several years later and developed osteonecrosis around the implants. In each case, the osteonecrosis occurred only around the implants and not around the patient’s remaining teeth. The implants of eight patients were removed with a sequestrum of bone tightly adherent to the implant. This is different from the normal pattern of implant failure. Implant failure can occur when patients with successfully integrated implants are later placed on anti-resorptive therapy, and the osteonecrosis takes a particular form where a sequestrum forms that remains adherent to the implant. Why the adjacent remaining teeth are not affected is unclear.

Key factors for developing a Successful UK-Surgical Ear Implant Registry

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Reclaiming the Lost Bastion for Successful Implant Therapy: A Case Series

Reclaiming the Lost Bastion for Successful Implant Therapy: A Case Series

Clinical Experience and Procedural Outcomes Associated with the DF4 Implantable Cardioverter Defibrillator System: The SJ4 Postapproval Study

Current implantable cardioverter defibrillators (ICDs) employ two or three low- and high-voltage lead connectors, adding complexity and bulk, sometimes resulting in incorrect connections and adverse events. The SJ4 study evaluates the performance of a novel integrated single-lead DF4 connection system by characterizing lead measurements, handling characteristics, and outcomes. Patients with standard guidelines-based ICD indications were enrolled and implanted with a St. Jude Medical™ DF4 system (St. Jude Medical, Sylmar, CA, USA; right ventricular high-voltage DF4 lead models 7120Q, 7121Q, 7122Q, or 7170Q with compatible ICD). Device electrical measurements, handling characteristics, and any adverse events were collected at implant and during each scheduled 6-month follow-up. Among 1,701 patients (65 ± 13 years, 72% male, left ventricular ejection fraction 29 ± 12%) enrolled at 58 centers, there were 1,697 successful implants (99.8% implant success; ICD; n = 999, cardiac resynchronization therapy-defibrillator n = 698). Implanting physicians reported that implantation of the DF4 lead was normal or easier than normal in 94% of cases with successful implant. These patients have been followed for 1.7 ± 0.5 years with a maximum follow-up of 2.5 years. The complication rate was 0.017 per patient year of follow-up (95% confidence interval: 0.013-0.023), which included abnormal defibrillation impedance, elevated pacing thresholds, failure to detect ventricular tachycardia/ventricular fibrillation, lead dislodgement, lead fracture, loss of capture, and lead perforation. There were no set screw-related complications at implant or during follow-up. The DF4 system overall performed very well with few complications at implant and in follow-up.

Alphasphere as a Successful Ocular Implant in Primary Enucleation and Secondary Orbital Implant Exchange

ABSTRACTPurpose: To describe the surgical technique for a novel poly-HEMA (2-hydroxyethyl methacralate)[PHEMA] implant (Alphasphere, Addition Technology, Des Plaines, IL) in primary enucleation and placement of secondary orbital implant.Methods: Retrospective chart review of all patients receiving an Alphasphere implant for primary enucleation or secondary implant exchange from October 2009 to 2011. Interval follow-up was performed again on January 2013. Patient demographics, indications for surgery, and post-operative complications were reviewed.Results: Twelve patients received an Alphasphere implant for primary enucleation (n = 10) or secondary exchange (n = 2), with follow-up that ranged from 2 weeks to 14 months. The study included 9 adult and 3 pediatric patients with a mean age of 40 years, range 8–82 years. The indication for enucleation included: painful blind eye (n = 9), enophthalmos with difficult prosthesis fit in cases of secondary implant exchange (n = 2), and prophylaxis for sympathetic ophthalmia (n = 1). Only one patient required removal of the implant, due to a sinus infection with subsequent extrusion of the implant. Otherwise, the only other complication experienced was slight implant migration (n = 1).Conclusion: This initial report indicates that Alphasphere can be successfully used in the management of an anophthalmic socket. The advantages of the Alphasphere implant include: it does not require tissue wrapping, extraocular muscles can be directly sutured to the implant, it maintains a smooth surface to limit risk of exposure due to conjunctival breakdown, and undergoes anterior orbital fibrovascular ingrowth which optimizes prosthesis location and socket motility.