ObjectiveTo study the effect of titanium particles on the proliferation, differentiation, and cytomorphology of osteoblasts, and to explore the possible internal relations and mechanism. MethodsCalvarial osteoblasts were separated from 10 newborn Sprague Dawley rats by repeated enzyme digestion, and were cultured in vitro. The cells were identified by alkaline phosphatase (ALP) staining and alizarin red staining. The cells at passage 3 were cultured with titanium particles culture medium at concentrations of 0.01, 0.05, 0.1, 0.5, and 1 mg/mL (0.01, 0.05, 0.1, 0.5, and 1 mg/mL groups). The absorbance (A) values were detected by cell counting kit 8 at 7 days after cultured to compare the effect of titanium particles at different concentrations on proliferation, and median lethal concentration was screened out. The expression of collagen type I was detected by ELISA to observe the effect of titanium particles on differentiation. The osteoblasts co-cultured with titanium particles of median lethal concentration (experimental group) for 7 days, and double fluorescence staining with FITC-phalloidine and propidium iodide was performed. The cytomorphology variation of osteoblasts after swallowing titanium particles was observed under laser scanning confocal microscope. The osteoblasts at passage 3 cultured with culture medium without titanium particles served as control group. ResultsThe cultured cells were identified as osteoblasts by ALP staining and alizarin red staining. Different concentrations of titanium particles could inhibit osteoblasts proliferation and differentiation in varying degrees, showing significant difference when compared with the control group at 7 days after culture (P<0.05). The cell proliferation and differentiation were decreased with increased titanium particles concentration; significant differences were found between the other groups (P<0.05) except 0.01 and 0.05 mg/mL groups (P>0.05). The median lethal concentration of titanium particles was 0.5 mg/mL. Laser scanning confocal microscope showed cellular shrinking, microfilaments distortion, pseudopodia contraction of osteoblasts that swallowed titanium particles in the experimental group. ConclusionTitanium particles can inhibit proliferation and differentiation of osteoblasts. The effect may be related to variation of cytomorphology after swallowing titanium particles.
OBJECTIVE To investigate the feasibility of prefabricating a specified shape autograft capable of transfer using coral and type I collagen as a carrier for recombinant human bone morphogenetic protein-2 (rhBMP-2). METHODS In this study, the composite of rhBMP-2, coral and type I collagen was made certain shape to prefabricate vascularized osteomuscular autograft capable of microvascular free tissue transfer and autogenous bone graft with certain shape and titanium implant in it. The composite was implanted in the iliac area in dog with the titanium implant at the same time. After 3 months and 4 and a half months of implantation, the composites were studied with gross measurement, X-ray, and histological examinations. RESULTS After 3 months, composited bone was turned to bone tissue, and the shape of iliac bone was changed with implant in it, bone interface was seen between new bone and implant. And new bone was matured after 4 and a half months. CONCLUSION Coral and type I collagen are effective carrier for rhBMP-2 to prefabricate vascular osteomuscular autograft with certain shape. The use of rhBMP-2 for tissue engineered microvascular free bone flaps has an unlimited potential and adds a new dimension to maxillofacial reconstruction.
Objective To systematically review the efficacy of poly-L-lactide (PLLA) material treatment versus titanium plates treatment for mandibular fractures. Methods We searched the Cochrane Library, PubMed, Embase, Chinese Journal Full-text Database, VIP Database, and Wanfang Database to collect literatures about randomized or non-randomized controlled trials using PLLA treatment (the trial group) versus titanium plates treatment (the control group) for mandibular fractures in the last ten years (from January 2007 to March 2017). The quality evaluation and data extraction were carried out by 2 reviewers independently and analyzed by Review Manager 5.3 software. Results A total of 8 literatures including 453 patients with mandibular fractures were included in this Meta-analysis. There was no significant difference in total complications between the two groups [odds ratio (OR)=0.98, 95% confidence interval (CI) (0.55, 1.75), P=0.95], including dislocation healing [OR= 0.96, 95%CI (0.46, 2.01), P=0.90], occlusal disturbance [OR=1.53, 95%CI (0.61, 3.87), P=0.37], infection [OR=0.63, 95%CI (0.23, 1.74), P=0.37], and secondary operation [OR=0.46, 95%CI (0.17, 1.27), P=0.14]. Conclusion There is no significant difference between PLLA and titanium plate in the treatment of mandibular fractures.
Objective To investigate the biocompatibility of diamond-like carbon(DLC) coated NickelTitanium shape memory alloy with osteoblasts cultured invitro. Methods Rabbit’s osteoblasts were incubated with DLCcoated NickelTitanium shape memory alloy disks and uncoated ones of equal size for 5 days. The control group（without shape memory alloy in culture media） was performed simultaneously. The cultured cells were counted and graphed. The samples from culture media were collected and the concentrations of alkaline phosphatase (ALP) and nickel（Ni2+） were measured from the 1st to 5th day respectively. Results The proliferation of osteoblasts and the concentration of ALP in both DLC-coated group and control gruop was higher than uncoated group. The proliferation of osteoblasts on the 3rd, 4th, and 5th day in both DLC-coatedgroup and control group was significantly higher than that in the uncoated group(P＜0.05). The concentration of ALP in DLC-coated group on the 2nd, 3rd, and 5th day and in the control group on the 3rd, 4th, and 5th day was significantly higher than that in the uncoated group(P＜0.05). The concentration of Ni2+ on the 3rd, 4th, and 5th day was significantly lower than that in the uncoated group(P＜0.05). Conclusion DLC- coated NickelTitanium shape memory alloys appears to have better biocompatibility with osteoblast cultured in vitro compared to uncoated ones.
Objective To compare the effectiveness of titanium elastic nail (TEN) and locking compression plate fixation in treating femoral subtrochanteric fracture in older children. Methods Between April 2015 and September 2016, 35 older children (aged 7-13 years) with femoral subtrochanteric fractures were treated, the clinical data were retrospectively reviewed. TEN fixation was used in 19 cases (group A) and locking compression plate fixation in 16 cases (group B). There was no significant difference in age, gender, sides, fracture causes, type of fracture, and time from injury to operation between 2 groups (P>0.05). The fluoroscopy times, operation time, intraoperative blood loss, fracture healing time were recorded and compared between 2 groups. The limb function was evaluated according to the Sanders scores and Flynnet al. outcome score. Results All the patients were followed up 6-24 months (mean, 11.46 months). The operation time, intraoperative blood loss, and fracture healing time of group A were significantly less than those of group B, but the fluoroscopy times of group A was significantly more than that of group B (P<0.05). All the fractures were healed, no breakage of screw, infection of deep tissue, nerve injury, osteonecrosis of the femoral head, or other complication occurred. At last follow-up, according to the Sanders scores, the results were excellent in 14 cases, good in 4 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 12 cases, good in 3 cases, and fair in 1 case in group B with an excellent and good rate of 93.75%; showing no significant difference between 2 groups (χ2=0.400, P=0.980). According to the Flynn et al. outcome score, the results were excellent in 13 cases, good in 5 cases, and fair in 1 case in group A with an excellent and good rate of 94.74%; the results were excellent in 11 cases, good in 3 cases, and fair in 2 cases in group B with an excellent and good rate of 87.50%; showing no significant difference between 2 groups (χ2=0.748, P=0.688). Conclusion Both TEN and locking compression plate have satisfactory outcomes for treating pediatric femoral subtrochanteric fractures. TEN method has minimally trauma, security, and faster fracture healing when compared with locking compression plate.
Objective To compare the clinical effects of treating prolapse of the cervical intervertebral disc by the Solis cage fusion, the titanium cage fusion or the autogenous iliac crest graft combined with the titanium plate fixation. Methods Sixty-four patients with prolapse of the cervical intervertebral discadmitted to hospital from February 2002 to May 2005 were retrospectively analyzed. In Group A, 20 patients (15 males and 5 females, aged 38.76 years, 30 intervertebral spaces) were treated with the Solis cage fusion, and the preoperative JOAscores were 9-16, averaged 11.4; in Group B, 21 patients (15 males and 6 females,aged 37-78 years, 23 intervertebral spaces) were treated with the titanium cagefusion, and the preoperative JOA scores were 8-13, averaged 10.1; in Group C, 23 patients (18 males and 5 females, aged 32-76 years, 28 intervertebral spaces)were treated with the autogenous iliac crest graft combined with the titanium plate fixation, and the preoperative JOA scores were 9-14, averaged 10.6. The comparative analysis was made among the 3 groups in the following aspects: X-ray exposure time, time working on the iliac bone, operation time, hemorrhage amount，complication incidence after operation, cervical vertebral fusion rate, symptom relief rate, and recovery rate of the JOA score. Results According to the follow-upfor 2-15 months averaged 12 months, the time working on the iliac bone was longer in Group C than in Groups A and B (11.5±2.4 vs 4.1±1.7 minand 4.2±1.9 min, P＜0.05); the operation time was longer in Group C than in Groups A and B (98.3±14.7 min vs 55.5±10.3 min and 56.8±12.6 min, P＜0.05); and the X-ray exposure time was longer in Group C than in Groups A and B (7.8±1.8 min vs 4.3±1.2 min and 4.2±1.3 min, P＜0.05). Also, the hemorrhage amount in Group C was much greater than in Groups A and B (145.8±19.3 ml vs 65.8±10.2 ml and 67.2±12.3 ml,P＜0.05). The postoperative complication rate was lower in Groups A and Bthan in Group C (P＜0.05). There was a significant difference in the complication rate in the cervical region between Group A (5.0%±1.8%) and Group B (14.3%±2.6%,Plt;0.05）. The fusion rate in Groups A and B was 100% 3-4 monthsafteroperation, and there was no difference when compared with that in Group C. The recovery rates of the JOA scores in the three groups were 81.9%±3.2%，78.9%±7.3%, and 76.3%±9.4%, respectively, and there was no significant difference among the three groups. Conclusion The Solis cage fusion has a better therapeutic effect in treating prolapse of the cervical intervertebral disc than the titanium cage fusion and the autogenous iliac crest graft combined with the titanium plate fixation. The Solis cage fusion also makes the operation easier, with a more rapid recovery rate and fewer postoperative complications in the patient.
In order to study the Titanium-bone interaction and integration mechanism, the titanium implant was implanted in the tibia of 9 Newzealand rabbits, and the Ti-bone interface performed for 1, 3, and 6 months were examined and analyzed by fluorescence microscope and advanced TOF-SIMS techniques. The results showed that Ti-bone tissue was integrated closely in a very reactive manner. Both physical and chemical integration occurred in the Ti-bone interface. The Ti-bone could diffuse into the bone tissue though the diffusion was very limited. It was up to 100 microns in depth during the early period. The diffusion density was high, and later in a smooth distribution. Furthermore, while Ti+ diffused into the bone tissue, other elements such as Ca+, OH-, O-, etc, could also diffuse into titanium in exchange. The growth pattern around the bone tissue was in two fashions, one was implantefugal and the other was implantopetal. In this study, based on the ionic distribution, osmosis and impurity elements distribution, the Ti-bone integration mechanism was discussed at molecular and atomic level.
Objective To investigate the curative effect of peritoneal drainage tube fixation with titanium clamp in 210 patients during laparoscopic operations. Methods The clinical data of 210 patients with peritoneal drainage fixation via titanium clamp during laparoscopic operations in this hospital were analyzed retrospectively. Results In 210 patients, drainage tube placement lasted for 5-20 d with an average of 8.5 d. No complications such as drainage tube drifting, position changing or obstructed drainage occurred, and all the patients were successfully extubated. Conclusion During laparoscopic operations, the method that drainage tube fixed with titanium clamp is simple with reliable drainage results, affirmed curative efficacy and obviously decreased operative complications, which is worthy of clinical practice and generalization.
Objective To investigate the clinical effect of free forearm flap and titanium mesh in repairing maxillary defects. Methods From January 2002 to November 2002,partial maxillectomy or maxillectomy wereperformed in 3 patients with maxillary gingival carcinoma, in 1 patient with palatine mucoepicermoid carcinoma and in 1 patient with maxillary sinus carcinoma. Maxillary defects were reconstructed withfree forearm flaps ranging from 4 cm×5 cm to 6 cm×7 cm and titanium mesh.The effect was estimated by clinical examination, CT and nasopharyngoscope. Results Five cases were followed up 515 months. All the flaps were alive. Facial, alveolar process and palatal contours were restored well. Epithelium was found on the nostril surface of the titanium mesh. The functions of speech and chew were restored well. Conclusion A combination of the free forearm flap and titanium mesh is an ideal method in reconstruction of maxillary defects.
The surface morphology of titanium metal is an important factor affecting its hydrophilicity and biocompatibility, and exploring the surface treatment strategy of titanium metal is an important way to improve its biocompatibility. In this study, titanium (TA4) was firstly treated by large particle sand blasting and acid etching (SLA) technology, and then the obtained SLA-TA4 was treated by single surface treatments such as alkali-heat, ultraviolet light and plasma bombardment. According to the experimental results, alkali-heat treatment is the best treatment method to improve and maintain surface hydrophilicity of titanium. Then, the nanowire network morphology of titanium surface and its biological property, formed by further surface treatments on the basis of alkali-heat treatment, were investigated. Through the cell adhesion experiment of mouse embryonic osteoblast cells (MC3T3-E1), the ability of titanium material to support cell adhesion and cell spreading was investigated after different surface treatments. The mechanism of biological activity difference of titanium surface formed by different surface treatments was investigated according to the contact angle, pit depth and roughness of the titanium sheet surface. The results showed that the SLA-TA4 titanium sheet after a treatment of alkali heat for 10 h and ultraviolet irradiation for 1 h has the best biological activity and stability. From the perspective of improving surface bioactivity of medical devices, this study has important reference value for relevant researches on surface treatment of titanium implantable medical devices.