Osteoimmunology drives dental implant osseointegration: A new paradigm for implant dentistry.

There is a complex interaction between titanium dental implants, bone, and the immune system. Among them, specific immune cells, macrophages play a crucial role in the osseointegration dynamics. Infiltrating macrophages and resident macrophages (osteomacs) contribute to achieving an early pro-regenerative peri-implant environment. Also, multinucleated giant cells (MNGCs) in the bone-implant interface and their polarization ability, maintain a peri-implant immunological balance to preserve osseointegration integrity. However, dental implants can display cumulative levels of antigens (ions, nano and microparticles and bacterial antigens) at the implant-tissue interface activating an immune-inflammatory response. If the inflammation is not resolved or reactivated due to the stress signals and the immunogenicity of elements present, this could lead implants to aseptic loosening, infections, and subsequent bone loss. Therefore, to maintain osseointegration and prevent bone loss of implants, a better understanding of the osteoimmunology of the peri-implant environment would lead to the development of new therapeutic approaches. In this line, depicting osteoimmunological mechanisms, we discuss immunomodulatory strategies to improve and preserve a long-term functional integration between dental implants and the human body. Scientific field of dental science: implant dentistry.

Coupling between Osseointegration and Mechanotransduction to Maintain Foreign Body Equilibrium in the Long-Term: A Comprehensive Overview.

The permanent interaction between bone tissue and the immune system shows us the complex biology of the tissue in which we insert oral implants. At the same time, new knowledge in relation to the interaction of materials and the host, reveals to us the true nature of osseointegration. So, to achieve clinical success or perhaps most importantly, to understand why we sometimes fail, the study of oral implantology should consider the following advice equally important: a correct clinical protocol, the study of the immunomodulatory capacity of the device and the osteoimmunobiology of the host. Although osseointegration may seem adequate from the clinical point of view, a deeper vision shows us that a Foreign Body Equilibrium could be susceptible to environmental conditions. This is why maintaining this cellular balance should become our therapeutic target and, more specifically, the understanding of the main cell involved, the macrophage. The advent of new information, the development of new implant surfaces and the introduction of new therapeutic proposals such as therapeutic mechanotransduction, will allow us to maintain a healthy host-implant relationship long-term.

Conceptos biomecánicos en la elección de un elemento de osteosíntesis: revisión bibliográfica / Biomechanical concepts for choosing osteosynthesis devices: bibliographic review

Se revisan los aspectos mecánicos, biológicos y técnicos para diferentes sistemas de osteosíntesis que pueden ser usados en el tratamiento de las fracturas de los huesos tubulares largos. Se muestran las pruebas de laboratorio y sus resultados, discutiéndose sus implicancias clínicas

Experiencia con el uso de placa AO-DCP en 12 casos de fracturas de fémur / Femoral shaft fractures about twelve cases treated with AO DCP-plate

Revisamos retrospectivamente 12 casos de fracturas de diáfisis femoral tratados con placa AO-DCP, entre los años 1983 y 1992. Todos los enfermos fueron hombres, con edad promedio de 30 años y con seguimiento de 18 a 40 meses. Usamos 11 placas DCP y en un caso una placa condilar. Injerto esponjoso inmediato, se utilizó en 10 casos y en 2 casos fue tardío. Hubo 4 casos (4,33 por ciento) casos con injurias asociadas (cabeza, tórax, abdomen); hubo fracturas asociadas en 7 casos (58,3 por ciento) y lesiones arteriales significativas en 2 casos (16,5 por ciento). Se logró consolidación ósea en 9 casos (75 por ciento) entre 4 y 6 meses; en 3 casos (25 por ciento) hubo retardo de consolidación o no-unión, debido a fatiga de la placa (2 casos, 16,6 por ciento) e infección en un caso (8,3 por ciento). Los resultados se registraron como buenos (enfermos sin molestias en 8 casos (66,6 por ciento)), regulares (dolor leve, inconstante más barostesia en 1 caso (8,3 por ciento)) y malo en 3 casos (2,5 por ciento) que corresponden a los 2 casos de fatiga del material y el caso de infección con una osteomielitis crónica como secuela