Biomechanical Investigation of the Osseointegration of Titanium Implants With Different Surfaces Placed With Allogeneic Bone Transfer.

Allogeneic grafts can be preferred to autogenous grafts in plastic and oral-maxillofacial surgery for vertical and horizontal bone deficiencies. Implant surface properties are an important factor in osseointegration. This study aims to evaluate the osseointegration levels of titanium implants with machined, sand-blasted, and acid-etched (SLA) and resorbable blast material (RBM) surfaces placed together with allogeneic bone tissue transplantations obtained from the tibia bone using biomechanical method. Twenty-five female Sprague-Dawley rats were included in the study. The rats were divided into groups in which machined (n=7), SLA (n=7), and RBM (n=7) surface implants were placed with the transplantation of bone taken from the tibia. Four rats (both left and right tibias) were used as donors. Grafts and implants were surgically placed in the corticocancellous part of the metaphyseal area of the tibia bones of rats. At the end of the 4-week experimental setup, all rats were killed, and the implants and surrounding bone tissue were subjected to biomechanical reverse torque analysis (N/cm). Sand-blasted acid-etched surface implants were observed to have higher biomechanical osseointegration levels than RBM and machined surface implants (P<0.05). No statistical difference could be detected between the RBM and machined surface implants (P>0.05). On the basis of the limited results of this study, it can be concluded that the osseointegration levels of SLA surface implants placed with allogeneic bone transplantation may be better than those of machined and RBM surface implants.

The Course of Diabetic Foot Infection in Elderly Patients: Data of Patients From Turkey.

With the aging population, it is expected that diabetes and related complications will increase rapidly. The aim of this study was to examine the signs and symptoms of diabetic foot infection in elderly individuals. Patients with diabetic foot infection were grouped as mild, moderate, and severe. Patients aged <65 years and those who did not meet the diagnosis of diabetic foot infection were excluded from the study. Only the first applications of patients who applied to the hospital multiple times with diabetic foot infection diagnosis were evaluated. 314 patients were included in the study. The mean age of the patients was 71.5 (±12). The number of patients aged 75 and over was 125 (39.8%). Of the patients, 25.7% had mild, 61.7% moderate, and 12.4% severe clinical forms. 131 (41.7%) of the patients had osteomyelitis. Amputation was performed in 112 of the patients. Antibiotic treatment was given to 102 patients only. While 89 patients died, a significant correlation was found between all groups between amputation rate and mortality frequency and clinical severity of diabetic foot infection (P < .001). In our study, it was observed that the clinical severity of diabetic foot infection was more severe and the overall mortality rate was higher in geriatric patients. In light of all these data, it can be concluded that an early and comprehensive roadmap should be followed in geriatric patients with diabetic foot infection who have an increased risk of morbidity and mortality.

Osseointegration Levels of Implants Placed With Allogenic and Xenogenic Bone Ring: An Experimental Biomechanical Analysis.

This in vivo study aimed to do a biomechanical analysis of the early period bone-implant connection of titanium implants simultaneously inserted with xsenogenic and allogenic bone ring. In this study, 28 Sprague Dawley female rats were used. Four rats were killed to obtain an allogenic bone ring, and after this, the remaining rats were divided into control (n=8), xsenogenic (n=8), and allogenic (n=8) bone ring groups. Titanium-machined surfaced implants were integrated right tibias of the rats. In controls, only implants were integrated into right tibias. In the greft groups, the implants were integrated simultaneously with bone rings. After 2 weeks of the experimental period, the rats were killed ,and titanium implants and surrounding bone tissues were removed for biomechanic analysis. After biomechanical reverse torque analysis bone-implant connection was determined as Newton/cm 2 ; in controls 3.26 (1.2 to 4.5), in allogenic ring group 3.37 (2 to 4.4), in xsenogenic ring group 5.93 (2.8 to 10). Statistically significant differences were not detected between the groups ( P >0.05). Within the limitation of this study, both allogenic and xsenogenic bone grafts could be successfully used in bone augmentation in implant surgery.

Co-Existence of Two Rare Entities in the Male Breast: Intraductal Papilloma and Angiolipoma.

Intraductal papilloma and angiolipoma lesions are very rare in male breasts and gynecomastia is the most common male breast pathology. A 52-year-old healthy Caucasian male patient with right nipple pain for one month and two subareolar and periareolar masses had no other abnormal clinical or laboratory findings. After ultrasound examination, pull-through excision was made with a circumareolar incision in both lesions and the samples were sent for pathological examination. Histopathological examination revealed intraductal papilloma and angiolipoma on the basis of gynecomastia. This case is unique because both lesions are extremely rare and this is the first report of concurrent occurrence in a male breast.

A New Inflammatory Marker of Clinical and Diagnostic Importance in Diabetic Foot Infection: Systemic Immune-Inflammation Index.

Diabetes and associated complications still pose an important public health problem. Osteomyelitis as especially seen in patients with diabetes is associated with increased rates of morbidity and mortality. The present study aimed to investigate the clinical and diagnostic significance of inflammatory markers, including the systemic immune-inflammation index (SII) and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and procalcitonin (PCT) to differentiate osteomyelitis and cellulitis. The present study included 96 patients with osteomyelitis (Group 1) and 151 patients with cellulitis (Group 2). Inflammatory markers were significantly elevated in Group 1 compared to Group 2 patients (p < 0.05). Furthermore, the correlation coefficients (rho) between SII and ESR, CRP, and PCT were 0.466 (p < 0.001), 0.627 (p < 0.001), and 0.501 (p < 0.001), respectively, as a result of Spearman's Rho analysis. Accordingly, a moderately positive relationship was found between the variables. The area under the curve (AUC) values for SII, ESR, CRP, and PCT in diabetic foot infection patients with osteomyelitis were 0.687, 0.722, 0.692, and 0.641, respectively. As a result of the Likelhood Ratio (LR) test, the cut-off values were 2.182 for SII (sensitivity: 39.8% and specificity: 79.8%), 76.5 mm/h for ESR (sensitivity: 59.1% and specificity: 73.1%), 109.5 mg/mL for CRP (sensitivity: 40.9% and specificity: 79.8%), and 0.44 ng/mL for PCT (sensitivity: 26.1% and specificity: 88.2%). In conclusion, given that the patients with osteomyelitis had much higher ESR, CRP, PCT, and SII levels combined with the fact that SII is a low-cost and easy-to-measure index, suggests that the same may serve as an effective and novel marker alternative to other inflammatory markers for predicting diabetic foot osteomyelitis.

In Vivo Evaluation of the Effects of B-Doped Strontium Apatite Nanoparticles Produced by Hydrothermal Method on Bone Repair.

In the present study, the structural, morphological, and in vivo biocompatibility of un-doped and boron (B)-doped strontium apatite (SrAp) nanoparticles were investigated. Biomaterials were fabricated using the hydrothermal process. The structural and morphological characterizations of the fabricated nanoparticles were performed by XRD, FT-IR, FE-SEM, and EDX. Their biocompatibility was investigated by placing them in defects in rat tibiae in vivo. The un-doped and B-doped SrAp nanoparticles were successfully fabricated. The produced nanoparticles were in the shape of nano-rods, and the dimensions of the nano-rods decreased as the B ratio increased. It was observed that the structural and morphological properties of strontium apatite nanoparticles were affected by the contribution of B. A stoichiometric Sr/P ratio of 1.67 was reached in the 5% B-doped sample (1.68). The average crystallite sizes were 34.94 nm, 39.70 nm, 44.93 nm, and 48.23 nm in un-doped, 1% B-doped, 5% B-doped, and 10% B-doped samples, respectively. The results of the in vivo experiment revealed that the new bone formation and osteoblast density were higher in the groups with SrAp nanoparticles doped with different concentrations of B than in the control group, in which the open defects were untreated. It was observed that this biocompatibility and the new bone formation were especially elevated in the B groups, which added high levels of strontium were added. The osteoblast density was higher in the group in which the strontium element was placed in the opened bone defect compared with the control group. However, although new bone formation was slightly higher in the strontium group than in the control group, the difference was not statistically significant. Furthermore, the strontium group had the highest amount of fibrotic tissue formation. The produced nanoparticles can be used in dental and orthopedic applications as biomaterials.

Evaluation of the effects of the systemic proton pump inhibitor-omeprazole on periimplant bone regeneration and osseointegration: An experimental study.

Objective: Investigations of the effects of proton pump inhibitors (PPIs) on bone healing have revealed that they affect bone regeneration negatively. The exact mechanism by which this adverse effect on bone tissue is not known. The aim of this study is to biomechanic and biochemical investigation of the effects of the PPIs on guided periimplant bone regeneration. Material & methods: Spraque dawley rats were divided controls (n = 8): there is no treatment during 8 week experimental period, PPI- Dosage 1 (n = 8) and Dosage 2 (n = 8): 5 mg/kg and 10 mg/kg omeprazol applied 3 times in a week with oral gavage during 8 weeks respectfully. Bone defects created half of the implant length circumferencial after implant insertion and defects filled with bone grafts. After experimental period the rats sacrified and implants with surrounding bone tissues were removed to reverse torque analysis (Newton), blood samples collected to biochemical analysis (glucose, AST, ALT, ALP, urea, creatinin, calcium, P). Results: Biomechanic reverse torque values did not revealed any statistical differences between the groups (P > 0,05). Conclusion: According the biomechanical and biochemical parameters PPIs does not effect the periimplant guided bone regeneration.

Effects of local application of the ankaferd blood stopper on osseointegration in three different surface titanium implants.

OBJECTIVE: Researchs of the effects of ankaferd blood stopper (ABS) on bone healing metabolism have revealed that it affects bone regeneration positively. The exact mechanism by which this positive effect on bone tissue metabolism is not known. The aim of this study is to biomechanic and biochemical analysis of the effects of the local ABS application on osseointegration of 3 different surfaced titanium implants. MATERIAL & METHODS: Spraque dawley rats were divided machined surfaced (MS) (n â€‹= â€‹10), sandblasted and large acid grid (SLA) (n â€‹= â€‹10) and resorbable blast material (RBM) (n â€‹= â€‹10) surfaced implants. ABS applied locally during the surgical application of the titanium implant before insertion in bone sockets. After 4 weeks experimental period the rats sacrificed and implants with surrounding bone tissues were removed to reverse torque analysis (Newton), blood samples collected to biochemical analysis (ALP, calcium, P). RESULTS: Biomechanic bone implant contact ratio detected higher in SLA surfaced implants compared with the RBM and controls (P â€‹< â€‹0,05). Phosphor levels detected lower in RBM implant group compared with the controls and SLA (P â€‹< â€‹0,05). Additionally; phosphor levels detected highly in controls compared with the RBM implants. CONCLUSION: According the biomechanical parameters ABS may be more effective in SLA and RBM surfaced implants when locally applied.

Evaluation of Effects of Systemic Zoledronic Acid Application on Bone Maturation in the Consolidation Period in Distraction Osteogenesis.

ABSTRACT: Distraction osteogenesis (DO) is a physiological process that generates new bone tissue formation, using progressively separated bone fragments. Recently, several techniques have been investigated to develop the maturation of the new bone tissue. Bisphosphonates was an effective material for the acceleration of bone formation in DO procedures. The purpose of this study was to evaluate the effects of the systemic zoledronic acid application at the beginning of the consolidation period on new bone genesis in a DO model of rat femurs. The rats were divided randomly into 3 groups, as follows: Control group (CNT group) (n = 10), zoledronic acid dosage-1 (n = 10), and dosage-2 (n = 10) groups (ZA-D-1 and ZA-D-2). No treatment was administered in controls, but DO was applied to the rat femurs. A single dose of 0.1 mg/kg and 0.2 mg/kg of zoledronic acid was administered systematically at the beginning of the consolidation period after the distraction in treatment groups, respectively. Histomorphometric analyses were performed on the original distracted bone area and the surrounding bone tissue. Osteoblasts, new bone formation, and fibrosis were scored. New bone formation in the ZA-D-1 and ZA-D-2 groups, when compared with the control group, was detected highly (P < 0.05). The numbers of osteoblasts in the ZA-D-1 and ZA-D-2 groups were higher when compared with the controls (P < 0.05). Fibrosis in the controls, when compared with the ZA-D-1 and ZA-D-2 groups, was found to be higher (P < 0.05). Zoledronic acid application is an effective method for bone maturation in consolidation period in DO.

Biomechanical and biochemical evaluation of the effect of systemic application of omeprazole on the osseointegration of titanium implants.

BACKGROUND: This study aimed to investigate the effects of systemic omeprazole treatment on the osseointegration of titanium implants. MATERIAL AND METHODS: After surgical insertion of titanium implants into the metaphyseal part of rats' both right and left tibial bones, the animals were randomly divided into three equal groups: control (n = 8), omeprazole dosage-1 (n = 8) (OME-1), and omeprazole dosage-2 (n = 8) (OME-2) and totally 48 implants were surgically integrated. The rats in the control group received no treatment during the four-week postoperative experimental period. In the OME-1 and OME-2 groups, the rats received omeprazole in doses of 5 and 10 mg/kg, respectively, every 3 days for 4 weeks. After the experimental period, the rats were euthanized. One rat died in each group and the study was completed with seven rats in each group. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissue were used for biomechanical reverse-torque analysis. In the biomechanical analysis, implants that were not properly placed and were not osseointegrated were excluded from the evaluation. RESULTS: One-way analysis of variance and Tukey's honestly significant difference test and Student's t test were used for statistical analysis. The reverse-torque test (control (n = 9), OME-1 (N = 7), and OME-2 (n = 7)) analysis of biochemical parameters (alkaline phosphatase, calcium, phosphorus, aspartate aminotransferase, alanine amino transferase, urea, and creatinine) revealed no significant differences between the groups (control (n = 7), OME-1 (N = 7), and OME-2 (n = 7)) (P > 0.05). CONCLUSIONS: Omeprazole had no biomechanical or biochemical effects on the osseointegration process of titanium implants.

Effects of Carnosine, Ankaferd, and Silver Sulfadiazine on an Experimental Burn Model: Roles of Irisin and HSP70.

In this study, the effects of carnosine, ankaferd, and 1% silver sulfadiazine applied topically on second-degree burns were investigated and the roles of irisin and Heat shock protein 70 (HSP70) in this healing process were evaluated. Ninety male albino rats were used and divided into five groups. The groups were classified as control, burn, burn + carnosine (CAR), burn + ankaferd (ABS), and burn + silver sulfadiazine (SS). It was found that level of irisin increased in the first week and decreased in the second week in the burn and CAR groups. In the ABS and SS groups, the level of irisin was determined that started to increase in the first week and continued to increase in the second week. The level of HSP70 was found to increased in the first week in burn and CAR groups and decreased in the second week, but started to increase in the second week in ABS and SS groups. Both levels of irisin and HSP70 were observed to decreased in all treatment groups in the third week. In this study, it was shown that ankaferd and silver sülfadiazine treatments cause an increase in the irisin levels in the early period and a gradually increase in HSP70 levels in the later period in burns. The inflammatory response was observed to be limited in the early period in the ankaferd and sulfadiazin groups. It was concluded that these findings were effective in early wound healing in burns.

The effect of caffeic acid phenethyl ester and Ankaferd Blood Stopper on the diabetic and nondiabetic gingival wound healing: an experimental study

Background/aim: Healthy wound healing is very important for patient comfort. Diabetes is one of the factors that negatively affect wound healing. Ankaferd Blood Stopper (ABS) and caffeic acid phenethyl ester (CAPE) are antiinflammatory and antimicrobial agents and may have positive effects on wound healing. Materials and methods: In this study, 72 male Wistar albino rats were used. Rats; control, CAPE, ABS, diabetes + control, diabetes + ABS and diabetes + CAPE groups were divided into 6 groups. A healthy 36 rats created diabetes using streptozotocin (STZ). A gingival wound was created using a 4-mm punch biopsy in the gingival tissue under the lower anterior incisors of the rats. Results: The comparison between the nondiabetic groups had a statistically significant positive effect compared to the control group of CAPE and ABS (P ˂ 0.05). In the comparison between ABS and diabetes + ABS groups and in the comparison between CAPE and diabetes + CAPE groups, a decrease in vascularization in diabetes + CAPE groups was observed and it was statistically significant (P ˂ 0.005). Conclusion: ABS and CAPE have been found to have positive effects on gingival wound healing in the nondiabetic group. We think that this situation is caused by its antiinflammatory and antimicrobial properties.

Biomechanical Evaluation of Implant Osseointegration After Guided Bone Regeneration With Different Bone Grafts.

ABSTRACT: The aim of this study was to compare the biomechanical osseointegration of titanium implants after guided bone regeneration (GBR) with a hydroxyapatite graft, deproteinized bovine bone graft, human-derived allograft, and calcium sulfate bone graft. Thirty-two female Sprague Dawley rats were divided into four groups, each containing eight (n = 8) rats: hydroxyapatide (HA), deproteinized bovine bone graft (DPBB), allograft (ALG), and calcium sulfate. Bone defects were created in the tibia of the rats, which were grafted with HA, DPBB, ALG, or CP bone grafts for the purpose of GBR. Ninety days after surgery, machine-surfaced titanium implants were inserted into the area where GBR had been undertaken. After 90 days of the surgical insertion of the implants, the rats were sacrificed, the implants with surrounding bone tissue were removed, and biomechanical osseointegration (N/cm) analysis was performed. No statistically significant differences were found among the groups in osseointegration (N/cm) three months after the GBR procedures (P > 0.05). According to the biomechanical results, none of the grafts used in this study was distinctly superior to any of the others.

The effects of metformin on the bone filling ration around of TiAl6Va4 implants in non diabetic rats.

OBJECTIVES: In this research it was aimed to that evaluation of the effects of systemic metformin administration on the periimplant bone tissue response of TiAl6Va4 implants in experimental rat model. MATERIALS AND METHOD: Firstly TiAl6Va4 implants were inserted surgically in the metaphyseal part of the tibial bone and after, the rats were randomly separated into two groups: Controls (CNT) (n = 10) and Metformin group (M) (n = 10). No additional treatment was applied to the controls during the 4-week experimental period. Rats received 40 mg/kg metformin in every day during the four week experimental period in M group. At the end of the 28-day follow-up period, the TiAl6Va4 implants with surrounding bone were used for the histopathologic analysis. To analysis of the datas between M and CNT Student-T Test was used. RESULT: Periimplant bone tissue filling ratios (%) were detected higher in M group compared with the CNT (P < 0.05). CONCLUSION: Systemic administration of metformin may increases titanium implant osseointegration in non-diabetic rats.