As demonstrated in the available literature dealing with recently developed and marketed oral implants, surface-roughening procedures also affect the surface chemical composition of oral implants. There is sufficient proof that surface roughening induces a safe and predictable implant-to-bone response, but it is not clear whether this effect is due to the surface roughness or to the related change in the surface composition. The review of the experimental surface alterations revealed that thin calcium phosphate (CaP) coating technology can solve the problems associated with thick CaP coatings, while they still improve implant bone integration compared with non-coated titanium implants. Nevertheless, there is a lack of human studies in which the success rate of thin CaP-coated oral implants is compared with just roughened oral implants. No unequivocal evidence is available that suggests a positive effect on the implant bone integration of peptide sequences or growth factors coated on titanium oral implants. In contrast, the available literature suggests that bone morphogenetic protein-2 coatings might even impede the magnitude of implant-to-bone response.
Collagen barrier membranes are frequently used in both guided tissue regeneration (GTR) and guided bone regeneration (GBR). Collagen used for these devices is available from different species and is often processed to alter the properties of the final product. This is necessary because unprocessed collagen is rapidly resorbed in vivo and demands for barrier membranes are different in GTR and GBR. This systematic literature review attempts to evaluate possible effects of collagen origin and mode of cross-linking on the potential of different cells to attach to, proliferate on, and migrate over barrier membranes in vitro. Seventeen original studies, selected by a systematic process, are included in this review. The results show that fibroblasts of different species and originating tissues as well as bone-forming cells are able to attach to collagen membranes irrespective of collagen origin or mode of processing. Different cell types behave differently on identical membranes. Many pieces of evidence are currently available, and we attempted to elucidate the effects of collagen origin and mode of processing on cellular behavior, but further research will be required before it will be possible to predict for certain the effect a specific procedure will have with a given product.
The prognosis of idiopathic sudden hearing loss depends on its severity; acute complete deafness, for example, has a particularly bad prognosis. The treatment of acute deafness is based on a systemic application of corticosteroids. Corticoid concentrations in the cochlea are higher after transtympanic application in comparison to systemic application. We therefore investigated whether an additional transtympanic corticoid therapy gives an advantage over systemic standard therapy. We report on 27 patients with sudden idiopathic profound hearing loss or deafness who were treated in the Department of Otorhinolaryngology, University of Essen, Germany. Fourteen patients were treated with a rheologic infusion therapy with systemic prednisolone. Thirteen patients were treated additionally with methylprednisolone (Urbason) transtympanically through a ventilation tube. In the first group of patients who were treated with infusion therapy and corticoids systemically, three patients had good recovery of hearing. Another five patients had a partial recovery of hearing. The average hearing gain from 0.5-4 kHz was 15 dB. In the group of patients who were treated additionally with local corticoids, two patients reported a good recovery of hearing and another two patients only had a partial recovery of hearing. The average hearing gain in the above-mentioned frequency range was 11 dB. In our patients the additional transtympanic application of corticoids did not result in a significantly improved recovery of hearing in comparison to the patients treated with the standard therapy alone.
Amongst the engineered nanomaterials, especially carbon nanotubes (CNTs) have received considerable attention for application in tissue engineering scaffolds. CNTs are considered promising on behalf of their physicochemical properties, yet such nanomaterials also have been associated with potentially hazardous effects on human health. To gain insight into the toxicity aspects of CNTs in vivo, the present study presents a systematic review of literature. After screening of literature through defined inclusion and exclusion criteria, and subsequent data extraction, it can be concluded that pulmonary administered CNTs have the capacity to induce toxicity in the lung area. However, conclusions for other organs, or on systemic toxicity, are yet premature. In addition, the carcinogenic potential of CNTs is also still ambiguous, because contradictive results are presented. Intrinsic factors, such as material characteristics, and associated distribution and agglomeration patterns influence the toxic potential of CNTs. Similarly, environmental factors such as the exposure route, preexisting allergies, pathological infections, or air pollutant exposure are significant. Despite the many reports published currently, more studies will be required to gain full understanding of the toxic potential of CNTs and especially the underlying mechanisms. For this end, development of standardized protocols and reliable nanodetection techniques will form prerequisites.
Application of enamel matrix protein derivative (EMD) onto a debrided and conditioned root surface has been shown to promote periodontal regeneration in animals and humans. However, until now there is virtually no information from humans describing the expression of different matrix molecules in the newly formed periodontal tissues following treatment with EMD. This study investigated immunohistochemically in humans the expression of matrix molecules associated with periodontal tissues reformed after treatment with EMD. Eight patients with intrabony defects were treated with EMD. Six months after surgery teeth together with some of their surrounding soft and hard tissues were removed, fixed in buffered formalin, decalcified in EDTA, and embedded in paraffin. Serial sections of 6 micro m were cut in mesiodistal direction. Sections were evaluated immunohistochemically by means of polyclonal antibodies against osteopontin, collagen I and collagen III. The original (non-treated) parts of the periodontium served as controls. In all specimens the healing resulted to a varying extent in formation of cementum, periodontal ligament and alveolar bone. In all specimens the expression of the investigated matrix molecules was stronger at the reformed than at the original sites. Osteopontin expression was most intense at the border near the newly formed cementum and bone. In the regenerated periodontal ligament, collagen I and III were localized throughout the entire periodontal ligament connective tissue. Within the newly formed PDL connective tissue the immunohistochemical staining appeared stronger for collagen III than for collagen I. The present findings suggest that (a) treatment of human intrabony defects with EMD creates an environment favourable for periodontal regeneration and, (b) in humans the healing and/or remodelling process of the reformed tissues may be followed immunohistochemically for a period of 6 months.
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