Schlottig, Falko
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Ultrasound melted polymer sleeve for improved screw anchorage in trabecular bone-A novel screw augmentation technique
2016-02-23, Schmoelz, Werner, Mayr, Raul, Schlottig, Falko, Ivanovic, Nikola, Hörmann, Romed, Goldhahn, Jörg
Background: Screw anchorage in osteoporotic bone is still limited and makes treatment of osteoporotic fractures challenging for surgeons. Conventional screws fail in poor bone quality due to loosening at the screw-bone interface. A new technology should help to improve this interface. In a novel constant amelioration process technique, a polymer sleeve is melted by ultrasound in the predrilled screw hole prior to screw insertion. The purpose of this study was to investigate in vitro the effect of the constant amelioration process platform technology on primary screw anchorage. Methods: Fresh frozen femoral heads (n=6) and vertebrae (n=6) were used to measure the maximum screw insertion torque of reference and constant amelioration process augmented screws. Specimens were cut in cranio-caudal direction, and the screws (reference and constant amelioration process) were implanted in predrilled holes in the trabecular structure on both sides of the cross section. This allowed the pairwise comparison of insertion torque for constant amelioration process and reference screws (femoral heads n=18, vertebrae n=12). Prior to screw insertion, a micro-CT scan was made to ensure comparable bone quality at the screw placement location. Findings: The mean insertion torque for the constant amelioration process augmented screws in both, the femoral heads (44.2Ncm, SD 14.7) and the vertebral bodies (13.5Ncm, SD 6.3) was significantly higher than for the reference screws of the femoral heads (31.7Ncm, SD 9.6, p<0.001) and the vertebral bodies (7.1Ncm, SD 4.5, p<0.001). Interpretation: The interconnection of the melted polymer sleeve with the surrounding trabecular bone in the constant amelioration process technique resulted in a higher screw insertion torque and can improve screw anchorage in osteoporotic trabecular bone.
Porous shape-memory-scaffolds as mechanically active bone implants
2015, de Wild, Michael, Hoffmann, Waldemar, Schlottig, Falko, Schumacher, Ralf, Bormann, Therese, Martin, Ivan, Müller, Bert, Mürrle, Ulrich
Ligature-Induced Peri-Implantitis in Minipigs Revisited
2016-02-22, Stübinger, Stefan, Bucher, Ramon, Kronen, Peter, Schlottig, Falko, von Rechenberg, Brigitte
Aim: The ligature-induced defect model still remains the model of first choice to experimentally investigate the cause, effect and treatment approaches of periimplantitis. It was the aim of the present in-vivo trail to revisit the ligature-induced peri-implantitis minipig model regarding its current scientific value and ethical justification in implant research. Materials and methods: Six minipigs were used for the analysis of peri-implant hard and soft tissue structures. Animals were randomly allocated to an experimental silk ligature-induced peri-implantitis group (n=4 animals) and a reference healthy group (n=2 animals). After six weeks mean pocket depths (PD) and bleeding on probing (BOP) measurements were performed just before animals were sacrificed. Results: Overall, ligature-induced peri-implantitis provoked a local inflammation around the experimental implants. Additionally, a loss of crestal bone surrounding the implants could be detected. Mean pocket depths (PD) were 2.2 ± 1.1 mm for healthy animals and 5.4 ± 1.9 mm for peri-implantitis sites. Healthy sites showed a BOP of 60%, whereas peri-implantitis sites disclosed a BOP of 90% within 10 s after probing. Conclusion: Clinical, radiological and histological findings of the present animal experiment supported the overall applicability of the ligature-induced periimplantitis minipig model. A rapid breakdown of peri-implant hard tissues could be detected mainly on the buccal side.
Synergistic interactions of blood-borne immune cells, fibroblasts and extracellular matrix drive repair in an in vitro peri-implant wound healing model
2016-02-17, Burkhardt, Melanie, Waser, Jasmin, Milleret, Vincent, Gerber, Isabel, Emmert, Maximilian, Foolen, Jasper, Hoerstrup, Simon, Schlottig, Falko, Vogel, Viola
Low correlations of cell culture data with clinical outcomes pose major medical challenges with costly consequences. While the majority of biomaterials are tested using in vitro cell monocultures, the importance of synergistic interactions between different cell types on paracrine signalling has recently been highlighted. In this proof-of-concept study, we asked whether the first contact of surfaces with whole human blood could steer the tissue healing response. This hypothesis was tested using alkali-treatment of rough titanium (Ti) surfaces since they have clinically been shown to improve early implant integration and stability, yet blood-free in vitro cell cultures poorly correlated with in vivo tissue healing. We show that alkali-treatment, compared to native Ti surfaces, increased blood clot thickness, including platelet adhesion. Strikingly, blood clots with entrapped blood cells in synergistic interactions with fibroblasts, but not fibroblasts alone, upregulated the secretion of major factors associated with fast healing. This includes matrix metalloproteinases (MMPs) to break down extracellular matrix and the growth factor VEGF, known for its angiogenic potential. Consequently, in vitro test platforms, which consider whole blood-implant interactions, might be superior in predicting wound healing in response to biomaterial properties.