ABSTRACT
BACKGROUND: The choice of standard femoral prosthesis or lengthened femoral prosthesis for the treatment of femoral intertrochanteric fracture in the elderly with hemihip replacement has always troubled clinicians. OBJECTIVE: To compare the short-term clinical efficacy of standard and long-stem prosthesis replacement in the treatment of elderly comminuted intertrochanteric Jensen V fractures. METHODS: Data of 216 elderly patients with comminuted intertrochanteric femoral Jensen V fractures undergoing bone cement artificial half hip arthroplasty in Loudi Central Hospital from January 2008 to January 2019 were retrospectively analyzed. According to the type of prosthesis, the patients were divided into standard stem prosthesis placement group (n=92) and long-stem prosthesis replacement group (n=124). According to the fracture situation, the wire Kirschner wire was used to reduce the trochanteric fracture. At 1 year after surgery, Hariss score of the hip joint was evaluated. X-ray examination was used to observe imaging manifestations around the prosthesis. RESULTS AND CONCLUSION: (1) Two patients in the standard stem prosthesis placement group died; three patients in the long-stem prosthesis replacement group died. The remaining patients were followed up for 12-24 months. (2) At 1 year after surgery, Hariss scores were (88.6±2.9) in the standard stem prosthesis placement group with an excellent and good rate of 83.3%, and (86.9±2.7) in the long-stem prosthesis replacement group with an excellent and good rate of 82.6%; no significant difference was found between the two groups (P > 0.05). (3) In the standard stem prosthesis placement group, one case affected femoral greater trochanteric fracture nonunion; two cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. In the long-stem prosthesis replacement group, one case affected femoral greater trochanteric fracture nonunion; three cases had femoral small trochanteric fracture nonunion; two cases experienced Brooker’s grade 1 heterotopic ossification. There was no significant difference in the incidence of complications between the two groups (P > 0.05). (4) It is indicated that the short-term clinical efficacy of standard and long-stem cement-type prosthesis replacement in the treatment of Jensen V type trochanteric fracture in elderly patients is satisfactory, with no statistical difference, but the long-term effect remains to be studied.
ABSTRACT
Introducción: Estudio experimental donde se procuró determinar el efecto osteoinductor del mineral trióxido agregado (MTA) versus el cemento Portland tipo I sobre lesiones óseas mandibulares. Metodología: Se emplearon 12 conejos machos de la raza New Zealand de 3 meses de edad, los cuales fueron divididos en 4 grupos iguales. Todos los conejos fueron anestesiados utilizando pentobarbital sódico. Se procedió a la incisión en la piel mandibular para exponer el hueso sobre el que se realizó 3 cavidades de 3mm cada una. En una cavidad se colocó MTA, en otra cemento Portland y en la tercena ninguna pasta. Se procedió al sacrificio de los grupos experimentales a la 1era, 2da, 3era y 4ta semana respectiva y se evaluó las muestras obtenidas de las áreas quirúrgicas mediante conteo de osteocitos y osteoblastos. Resultados: Tanto el MTA como el cemento Portland poseen la misma capacidad osteoinductiva en la 1era, 2da y 3era semana (p>0,05). Sin embargo, en la 4ta semana el MTA tuvo mayor capacidad osteoinductora al estimular mayor número de osteoblastos que el cemento Portland (p=0,024). Conclusiones: El MTA y el cemento Portland tipo I mostraron similar efecto osteoinductor durante las 3 primeras semanas de evaluación. El MTA demostró mayor efecto osteoinductor durante la cuarta semana de valoración.
Introduction: An experimental study was carried out to determine the osteoinductive effect of Mineral Trioxide Aggregate (MTA) versus Portland Cement type I on mandibular bone lesions. Methodology: Twelve 3-month-old male New Zealand rabbits were divided into 4 equal groups. All rabbits were anesthetized using Pentobarbital. An incision of the mandibular skin was performed to expose the bone on which 3 cavities of 2mm each one were made. In one cavity MTA was placed, in another Portland Cement type I and the third remained empty. The experimental groups were sacrificed at the 1st, 2nd, 3rd and 4th respective weeks and evaluated histologically by counting osteocytes and osteoblasts. Results: Both MTA and Portland cement have the same osteoinductive capacity in the 1st, 2nd and 3rd week (0.05
ABSTRACT
PURPOSE: This study was aimed to compare the radiopacity of four kinds of currently available resin based implant cements using digital radiography. MATERIALS AND METHODS: Four resin-based implant cements ((Estemp Implant(TM) (Spident, Incheon, Korea), Premier(R) Implant (Premier, Pennsylvania, USA), Cem-Implant(TM) (B.J.M lab, Or-yehuda, Israel), InterCem(TM) (SCI-PHARM, California, USA)) and control group (Elite Cement 100(TM) (GC, Tokyo, Japan)) were mixed and cured according to the manufacturer's instructions on the custom made split-type metal mold. A total of 150 specimens of each cement were prepared and each specimen (purity over 99%) was placed side-by-side with an aluminum step wedge for image taking with Intraoral X-ray unit (Esx, Vatech, Korea) and digital X-ray sensor (EzSensor, Vatech, Korea). For the evaluation of aluminum wedge equivalent thickness (mm Al), Image J 1.47 m (Wayne Rasband, National Institutes of Health, USA) and Color inspector 3D ver 2.0 (Interaktive Visualisierung von Farbraumen, Berlin, Germany) programs were used. RESULT: Among the 5 cements, Elite cement 100(TM) (control group) showed the highest radio-opacity in all thickness. In the experimental group, InterCem(TM) had the highest radio-opacity followed by Premier(R) Implant Cement(TM), Cem-Implant(TM) and Estemp Implant(TM). In addition, InterCem(TM) showed radio-opacity that met the ISO No. 4049 standard in all the tested specimen thickness. Cem-Implant on 0.5 mm thickness showed radiopacity that met the ISO No. 4049 standard. CONCLUSION: Among the implant resin-based cements tested in the study, Premier(R) Implant Cement and Estemp Implant(TM) did not show appropriate radio-opacity. Only InterCem(TM) and Cem-Implant(TM) 0.5 mm specimen had the proper radiopacity and met the experiment standard.
Subject(s)
Aluminum , Berlin , California , Fungi , Pennsylvania , Peri-Implantitis , Radiographic Image EnhancementABSTRACT
STATEMENT OF PROBLEMS: Stress analysis on implant components of the combined screw- and cement-retained implant prosthesis has not investigated yet. PURPOSE: The purpose of this study was to assess the load distribution characteristics of implant prostheses with the different prosthodontic retention types, such as cement-type, screw-type and combined type by using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-dimensional finite element model was created in which two SS II implants (Osstem Co. Ltd.) were placed in the areas of the first premolar and the first molar in the mandible , and three-unit fixed partial dentures with four different retention types were fabricated on the two SS II implants. Model 1 was a cement-retained implant restoration made on two cement-retained type abutments (Comocta abutment; Osstem Co. Ltd.), and Model 2 was a screw-retained implant restoration made on the screw-retained type abutments (Octa abutment; Osstem Co. Ltd.). Model 3 was a combined type implant restoration made on the cement-retained type abutment (Comocta abutment) for the first molar and the screw-retained type abutment (Octa abutment) for the first premolar. Lastly, Model 4 was a combined type implant restoration made on the screw-retained type abutment (Octa abutment) for the first molar and the cement-retained type abutment (Comocta abutment) for the first premolar. Average masticatory force was applied on the central fossa in a vertical direction, and on the buccal cusp in a vertical and oblique direction for each model. Von-Mises stress patterns on alveolar bone, implant body, abutment, abutment screw, and prosthetic screw around implant prostheses were evaluated through 3-dimensional finite element analysis. RESULTS: Model 2 showed the lowest von Mises stress. In all models, the von Mises stress distribution of cortical bone, cancellous bone and implant body showed the similar pattern. Regardless of loading conditions and type of abutment system, the stress of bone was concentrated on the cortical bone. The von-Mises stress on abutment, abutment screw, and prosthetic screw showed the lower values for the screw-retained type abutment than for the cement-retained type abutment regardless of the model type. There was little reciprocal effect of the abutment system between the molar and the premolar position. For all models, buccal cusp oblique loading caused the largest stress, followed by buccal cusp vertical loading and center vertical loading. CONCLUSION: Within the limitation of the FEA study, the combined type implant prosthesis did not demonstrate more stress around implant components than the cement type implant prosthesis. Under the assumption of ideal passive fit, the screw-type implant prosthesis showed the least stress around implant components.