Influence of three currently used bone replacing materials on the in vitro proliferation of human peripheral blood mononuclear cells.

OBJECTIVES: A cell culture system for biocompatibility testing of bone grafting materials is described. We investigated the in vitro viability and proliferative response of peripheral blood mononuclear cells (PBMC) from 10 healthy donors in the presence of three materials currently used for bone grafting: Algipore, Bio-Oss and Bone Source, for immunologic biocompatibility testing. MATERIAL AND METHODS: PBMC isolated from venous blood from 10 healthy donors were incubated for 4 days with each bone replacing material, in the presence and absence of interleukin-2 (IL-2). After 4 days, H3-thymidine was added for 18 h and the incorporated radioactivity was measured with a beta-plate counter. RESULTS: Basal PBMC counts were 152.9+/-66.2 counts per minute (c.p.m.) (mean+/-SD), in the presence of 0.4 U IL-2/well 206.5+/-83 c.p.m. were measured. With Algipore and Bio-Oss, which are deproteinized bone replacing materials, the proliferation rate of PBMC with IL-2 was not significantly modified: for Algipore 151+/-51 c.p.m./+IL-2 188.8+/-62 c.p.m., for Bio-Oss 144.5+/-64.9 c.p.m./+IL-2 176.3+/-71.23 c.p.m. For Bone Source 164.2+/-80.4/+IL-2 188.3+/-81 c.p.m. were measured. CONCLUSION: This in vitro experiment indicates, that the investigated bone replacing materials are not acting as specific antigens/haptens and are not generating increased proliferative responses of human PBMC from healthy donors. Even with IL-2, that induces proliferation of T lymphocytes, which encountered their specific antigen, the proliferation rate of PBMC from healthy donors was not increased after incubation with this bone grafting materials.

The Er:YAG laser in endodontics: results of an in vitro study.

BACKGROUND AND OBJECTIVE: Until recently, the main field of Er:YAG laser application was the removal of dental hard substances within the scope of cavity preparation. Nowadays, several new delivery-systems are available, permitting the application of the Er:YAG laser in endodontics. The aim of the present study was to assess the effects of Er:YAG laser irradiation on root canals in vitro. STUDY DESIGN/MATERIALS AND METHODS: For this purpose, 220 extracted human teeth were endodontically processed and subsequently irradiated at different settings using an Er:YAG laser imitating in vivo irradiation procedures. The teeth were then subdivided into three groups and subjected to bacteriological evaluations, scanning electron microscopy, and temperature measurements. RESULTS: The bacteriological evaluation revealed a decisive bactericidal effect of the Er:YAG laser in the root canal. The bactericidal effect was dependent on the applied output power and specific for the different species of bacteria investigated. Scanning electron microscopy showed discrete removal of dentine from the root canal walls. The temperature rise during irradiation was moderate when standardized power settings were used. CONCLUSION: The investigations indicate that the Er:YAG laser is a suitable tool for the elimination of bacteria in root canals under in vitro conditions.

Evaluation of accuracy of computer-aided intraoperative positioning of endosseous oral implants in the edentulous mandible.

The overall accuracy of a novel surgical computer-aided navigation system for placement of endosseous implants was evaluated. Five dry cadaver mandibles were scanned using high resolution computed tomography (HRCT). The position of four interforaminal dental implants was planned on the computer screen and transferred to the cadaver mandibles using VISIT, a surgical navigation software developed at the Vienna General Hospital. The specimens were HRCT-scanned again to compare the position of the implants with the preoperative plan on reformatted slices after matching of the pre- and postoperative data sets using the mutual information technique. The overall accuracy was 0.96 +/- 0.72 mm (range 0.0-3.5 mm). No perforation of the mandibular cortex or damage to the mandibular canal occurred. We conclude that computer-aided implant surgery can reach a level of accuracy where further clinical developments are feasible.

Computer-enhanced stereoscopic vision in a head-mounted display for oral implant surgery.

We developed a head-mounted display (HMD) with integrated computer-generated stereoscopic projection of target structures and integrated it into visit, a specific oral implant planning and navigation software. The HMD is equipped with two miniature computer monitors that project computer-generated graphics stereoscopically into the optical path. Its position is tracked by the navigation system's optical tracker and target structures are displayed in their true position over the operation site. In order to test this system's accuracy and spatial perception of the viewer, five interforaminal implants in three dry human mandibles were planned with visit and executed using the stereoscopic projection through the HMD. The deviation between planned and achieved position of the implants was measured on corresponding computed tomography (CT) scan images recorded post-operatively. The deviation between planned and achieved implant position at the jaw crest was 0.57 +/- 0.49 mm measured from the lingual, and 0.58 +/- 0.4 mm measured from the buccal cortex. At the tip of the implants the deviation was 0.77 +/- 0.63 mm at the lingual and 0.79 +/- 0.71 mm at the buccal cortex. The mean angular deviation between planned and executed implant position was 3.55 +/- 2.07 degrees. The present in vitro experiment indicates that the concept of preoperative planning and transfer to the operative field by an HMD allows us to achieve an average precision within 1 mm (range up to 3 mm) of the implant position and within 3 degrees deviation for the implant inclination (range up to 10 degrees ). Control during the drilling procedure is significantly improved by stereoscopic vision through the HMD resulting in a more accurate inclination of the implants.