Key Engineering Materials Vol. 638

Abstract: Introduction Between 2004-2006 in Moscow at the Russian University of People’s Friendship Department of Orthopaedic and Traumatology under the lead of Alexandr Laka, there have been created more new instruments, which allowed individualised treatment for each scoliotic patient.Case outline The case that we bring to your attention belongs to the patients group to which the deformation practically reached it’s final form. The patient is known with dextroconvex thoraco-lumbar idiopathic scoliosis that set out at the age of 11 years. Despite a long physical treatment, the deformity progressed reaching by the time she addressed to us, a critical stage with a 90º Cobb angle and 45º rotation at T9 apical vertebrae. Surgery was performed by using LSZ implant for correction of scoliotic deformity. The surgical technique is described step by step and the final result was a good tridimensional correction. Postoperatory X-Ray demonstrates 50% correction, with Cobb angle of 45º and 15% torsion correction.Conclusion The good result obtained in the case described, as well as in the studies published in literature, demonstrates that this technique is efficient for correction of scoliotic deformities both in frontal and sagittal plane, easy to perform and associated with a minimal risk for complications and encourage us to recommend this technique to other spine surgery departments.

Abstract: The materials used in manufacturing the implant supported prosthesis may influence the occlusal stress distribution to the bone due to their different elastic modulus. Thus, compared with alloys of Co-Cr, the material currently used for the realization of the implant supported prosthesis’ resistance structure, the titanium prosthesis’ elasticity allows a less rigid solidarization, especially important as the extent of the bridge is greater, more so in the mandible, which presents an elastic deformation during mastication.The use of modern composite materials based on polyether-ether-ketones for manufacturing the implant supported prosthesis’ resistance structure is gaining more and more interest due to optimization opportunities of the distribution of masticatory forces around the implant.Regarding the aesthetic component of the implant supported prosthesis, ceramic masses remain the most commonly used materials due to their outstanding restorer options and proven biocompatibility. However, speaking of the transmission of forces to the implant support, the composite materials are preferred due to advantages related to the possibility of stress relief and to ensure a durable link frame - composite, the aesthetic result being more than satisfying.

Abstract: Different types of stimuli responsive polymers that respond with a property change to a variation in the environmental conditions are an attractive class of materials for advanced applications in biomedical or pharmaceutical fields. Three types of responsive biocompatible and biodegradable polymer matrices are presented as potential biomaterials for medical application as carriers for various drugs and tissue engineering substitutes. Hybrid hydrogels based on collagen/ N-isopropyl acrylamide containing montmorillonite nanoparticles are promising materials for tissue engineering and also as carriers for norfloxacin, a chemotherapeutic antibacterial agent. Semi-interpenetrated hydrogels based either on substituted anhydride modified collagen and 2-hydroxyethyl methacrylate or on alginate and poly (N-isopropylacrylamide) were tested as matrices for the controlled delivery of bisoprolol fumarate, an antihypertensive drug and respectively of ketoprofen, a non-steroidal anti-inflammatory drug.

Abstract: The study presented in this paper was conducted to assess the main causes of osteosynthesis implants failure, among which implant material defects and unstable osteosynthesis fixation occur. A total number of 42 patients with osteosynthesis implant failure were included in this study in the Orthopedics and Traumatology Clinic of Bucharest Emergency University Hospital. The osteosynthesis implants failure was determined using radiological examination, only the patients with the age between 18 and 60 were selected. From the total number of patient included in our study, 18 had osteosynthesis performed with open reduction and plates and screws fixation, 5 intramedullary implants with open reduction, 4 intramedullary implants with close reduction, 15 cases of fixation with locking screws. For evaluating the macroscopic and microstructural features of the failure, we use microscopically techniques like stereomicroscopy, optical microscopy and scanning electron microscopy (SEM) techniques in conjunction with radiological images. After our analysis, in 14 cases we found a correct fixation but the microscopic examination of the implant materials reveals cracks in their structure, 24 cases showed an imperfect reduction of the fracture with interfragmentary diastasis and malrotation, and 4 had inadequate size devices, where the examination of failed metallic implants revealed no structural defects in implant materials. The results of our study showed that both design errors and inappropriate surgical procedures were causes of osteosynthesis failure. Therefore, special attention should be paid to the surgical fixation procedure but also to the fixation implant materials used.

Abstract:

The brackets collating technique and microbial factors increase the risk for enamel demineralization in patients with fixed orthodontic appliance. The aim of this study was to determine the risk level of enamel demineralization in fixed orthodontic device bearers. The enamel demineralization was assessed in 187 patients by measuring dental structure by fluorescent light. The measurements were performed with the DIAGNOdent Pen 2190 (KaVo, Biberach, Germany). Except canines which remain in the risk 1 category, without enamel demineralization, the other investigated teeth may have a medium demineralization degree The values recorded with fluorescent light on canine enamel showed low and insignificant differences (p>0.05) as a result of fixed orthodontic appliances, classifying these teeth as healthy teeth with enamel integrity or with low enamel demineralization. The molars presented significantly increased values in the study group as compared to the control group (p<0.05). 6 years molars had a marked predisposition to demineralization and caries as compared to frontal group teeth, after fluorescent light measurements. The measurements include these teeth in the medium to high risk for dental caries. The DIAGNOdent, due to its capacity to determine the demineralization degree of dental surfaces, may be used to monitor patients and to prevent the occurrence of dental caries during fixed orthodontic treatments.

Abstract: This paper presents some aspects from last 10 years of experience, when we used the hyaluronic acid produced and traded by a certain company, to obtain aesthetic good results in the treatment of the facial wrinkles, nazolabial folds, augmentation of the lips, face rejuvenation and hydration, correction of soft tissues deficiencies after major surgical operations.

Abstract: Introduction The mastoid has many functional roles that are well known in the literature. Less studied is the role of the mastoid in kinetic energy absorption during head trauma. The work hypothesis of this study was the question whether the mastoid obliteration with bone-like material plays a role in skull base traumatology during occipital trauma. Materials and methods The study was approved by the Ethics Committee of the University of Medicine and Pharmacy "Iuliu Haţieganu" from Cluj-Napoca and was performed on a formolized cephalic extremity. The calvaria was removed through a horizontal section in the upper third of the lambdoid suture, and the brain was also removed. The mastoid cells of the left temporal bone were removed by external approach. The resulting neocavity was filled with a mixture of calcium carbonate, white gypsum and hydroxyapatite. The mastoid cells of the right temporal bone remained intact. The occipital region of the cephalic extremity was impacted by a spherical object attached to a pendulum arm. Temporal bone fractures were evaluated by CT examination. Results The cephalic extremity was initially impacted at a speed of 3.55 m/s, with a kinetic energy of 56.71 J, which caused a fracture with depression in the occipital region, without causing temporal bone fracture. Subsequently, the same cephalic extremity was impacted at a speed of 4.13 m/s, with a kinetic energy of 76.75 J, which produced occipital comminuted fracture and right petrous apex fracture. Conclusions During the occipital impact on the studied cephalic extremity, the obliterated mastoid may play a higher role in protecting vital structures than the native mastoid.

Abstract: Introduction: BMAC-Harvest is an innovational method regarding autogenous stem cell treatments in various fields of medicine. In osteoarticular pathology it is used for treating chronic pathology cases as well as acute and traumatic ones. Purpose: The purpose of this study was to represent the clinical and imaging results of the patients presented to the Ist Orthopedic and Traumatology Clinic of Targu Mures. The results were obtained in the period 2012-2014 after using BMAC-Harvest autologous stem cells. Material and method: For this study the authors have included 28 patients from the Ist Orthopaedic and Traumatology Clinic of Targu Mures, suffering from different musculoskeletal pathologies. The method used on these patients was a surgical treatment, which consisted of injecting BMAC-Harvest autogenous stem cells in a unique dosage. The procedure was conducted in the operating room in sterile conditions. These cells were extracted from the iliac crest after appropriate preparation and general anesthezia. Patients were evaluated from a clinical and imaging point of view at periods of 3, 6 and 12 months after treatment. In the evaluation the following aspects were monitorized in the form of questionnaires: level of satisfaction, mobility and the daily activities of patients. The pain intensity of the patients was measured by using the VAS scale (visual analog scale). For imaging representations the authors used standard radiography and IRM in 2 occurrences and have taken into account every sign which appeared after the treatment.Results: The satisfaction level of the patients was significantly increased after the 12th month evaluation compared to results after 3rd month. The pain got considerably reduced and most of the patients could resume their activity from before the treatment. 4 patients have reported mild and medium pain 12 months after the treatment. Conclusion: Autogenous stem cell treatment is an innovational technique with satisfying results for short and medium periods. The BMAC-Harvest autogenous stem cells can be used with clear indications in locomotor organ pathology and it can help in the recuperation of the patient after a trauma. The BMAC-Harvest autogenous stem cells increase the formation of callus after a fracture or pseudoarthrosis. This is an innovational procedure and it can be used successfully in osteoarticular pathology both chronic and acute.

Abstract: The improvements in tooth-coloured filling materials generated more direct conservative techniques, making possible the achievement of optimal functional and aesthetic outcomes, in anterior and posterior teeth. Erosive acid-induced lesions of enamel or dentin often need restorative procedures. Nowadays, mostly aesthetic direct restoratives, which are adhesively fixed to the tooth surface are used for this purpose [1]. Several authors have concluded that direct restorations may lead to rehabilitation of eroded dentition in a less invasive manner [2], achieving adequate shaped, coloured and functional restorations. This in vitro study was carried out to evaluate, using micro energy-dispersive X-ray spectrometry (EDX) and scanning electron microscopy (SEM), the effects of an erosive challenge on different current direct restorative materials. It was aimed to provide information on aesthetic dental filling materials regarding their relative abilities to resist to erosive attack. The tested null hypothesis was that exposure to erosive solutions would influence surface degradation and chemical composition of the evaluated dental restoratives.

Abstract: Bisphosphonates currently represent the main therapy in the fight against osteoporosis. This is a serious condition, with an increasing incidence, presently affecting about 12 million people in the U.S. mostly women aged over 50 years. Thus, approximately 40% -50% of them suffer an osteoporotic fracture. Bisphosphonates mechanism of action consists in reducing osteoclast-mediated bone resorption, modifying bone turn over, leading to an increase in bone density. This dramatically reduces the risk of fracture. Although bisphosphonates shows a good safety profile, lately emerged some alarm signals that link their long management to some unusual side effects. Bisphosphonates is an effective therapy to combat osteoporosis, their causal relationship with FAF production not being shown. In the absence of other evidence, it is unclear whether BF therapy is directly involved in producing FAF or only a component of a combination of factors, in reality being just an indicator of a severe degree of osteoporosis. In the same time, we must not forget that the FAF are very rare compared to the number of patients in therapy with BF and the number of typical femur fractures, and the risk / benefit ratio it is definitely in favor of the benefit.