| 1. |
- Fröjd, Victoria, 1986, et al.
(författare)
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Importance of Ca(2+) Modifications for Osseointegration of Smooth and Moderately Rough Anodized Titanium Implants - A Removal Torque and Histological Evaluation in Rabbit.
- 2012
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 14:5, s. 737-745
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Tidskriftsartikel (refereegranskat)abstract
- Background: Incorporation of Ca(2+) into the titania of anodized titanium surfaces has been found to enhance osseointegration. It provides a stable surface when the ions are incorporated into the oxide layer during the anodizing process. The Ca(2+) may suggestively be prominent sites for mineral induction, attract proteins, and catalyze intracellular cascades. Purpose: The aim of the present study was to evaluate the osseointegration of smooth (S(a) < 0.5µm) and moderately rough (S(a) 1.0-2.0µm) commercially pure titanium implants, with and without Ca(2+) , in order to reflect on the importance of surface chemistry in relation to topography. Materials and Methods: Anodized implants with (OxCa) or without Ca(2+) (Ox), blasted implants (Bl), and blasted anodized implants, with (BlOxCa) or without Ca(2+) (BlOx), were inserted in rabbit femur and tibia. The implant surfaces were characterized using interferometry, scanning electron microscopy, and X-ray photoelectron spectroscopy prior to implant installation. Removal torque (RTQ) measurements were executed on all implants after a healing period of 12 weeks. The implants were, thereafter, removed en bloc with surrounding tissues and prepared for histological evaluations. Results: RTQ measurements of tibial implants revealed significantly higher values for BlOxCa implants (90.7 ± 23.3 Ncm) compared to OxCa (64.6 ± 18.2 Ncm) and BlOx implants (69.7 ± 17.5 Ncm) (p = 0.029). Ca(2+) modification of smooth implants placed in the femur did not reveal any differences. Conclusion: Ca(2+) modification of smooth implants resulted in similar interfacial shear strength as moderately rough implants and Ca(2+) modification of moderately rough implants demonstrated the significantly strongest interfacial shear strength when placed in rabbit tibia. This possibly demonstrated surface chemistry compensating for lesser roughness.
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| 2. |
- Fröjd, Victoria, 1986, et al.
(författare)
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Increased bone contact to a calcium incorporated oxidized c.p. titanium implant: an in vivo study in rabbit.
- 2008
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027. ; 37:6, s. 561-566
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the bone response to an oxidized titanium implant (Ox) and a calcium-incorporated oxidized titanium implant (Ca). A blasted titanium implant (Bl) was used as control. The implants were topographically characterized using an optical interferometer and placed: one in each distal femoral metaphysis and two in each proximal tibial metaphysis in rabbits. The rabbits were killed 12 weeks after implant insertion, and the implants and their surrounding tissues were removed en bloc for histomorphometrical evaluations. Topographical evaluation revealed three different surfaces: average height deviation (S(a), microm) values for Ca:Ox:Bl implants were 0.3:0.6:0.9, developed surface area ratios (%) 17:44:31, number of summits per microm(2) 208:136:118, and core fluid retention index values 1.33:1.33:1.38. The mean percentages of bone contact to the implants placed in the tibia (Ca:Ox:Bl) were 47:30:34 and to the implants placed in the femur (Ca:Ox) 32:20. The mean percentages of surrounding bone area for the implants placed in the tibia were 40:47:37 and for the implants placed in the femur 43:46. A significant increase in bone contact was found for smooth (S(a) <0.5 microm) but more densely peaked calcium-incorporated oxidized implants when compared to slightly rougher (S(a)=0.5-1.0 microm) oxidized or blasted implants.
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| 3. |
- Fröjd, Victoria, 1986, et al.
(författare)
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Conservative Healing of an 11×9-cm Aplasia Cutis Congenita of the Scalp with Bone Defect.
- 2014
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Ingår i: Journal of neurological surgery reports. - : Georg Thieme Verlag KG. - 2193-6358 .- 2193-6366. ; 75:2
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesAplasia cutis congenita is a rare congenital condition, and it is difficult to find scientific support for optimal treatment strategies. In addition, these may vary due to defect size, tissue layers involved, contemporary malformations, and the physiologic status of the affected child. Clinical PresentationThis case report describes complete skin coverage in 20 weeks and uneventful healing of a large 11×9-cm defect of the vertex, involving both skin and skull bone, using conservative treatment. To prevent infection and promote healing, the defect was kept moist and covered at all times, and it was treated with surgical debridement when necessary. For infection control, ionized silver-coated dressings were used in addition to prophylactic antibiotics over the first 3.5 weeks. Follow-up was 2 years. ConclusionSurgical treatment is usually preferred for larger aplasia cutis congenita defects, but it is accompanied with potential risks and will exacerbate secondary reconstruction of alopecia or skull bone defects. This case shows that even very complex defects may be treated conservatively.
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| 4. |
- Fröjd, Victoria, 1986, et al.
(författare)
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Effect of nanoporous TiO2 coating and anodized Ca2+ modification of titanium surfaces on early microbial biofilm formation.
- 2011
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Ingår i: BMC oral health. - London, UK : Springer Science and Business Media LLC. - 1472-6831. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- The soft tissue around dental implants forms a barrier between the oral environment and the peri-implant bone and a crucial factor for long-term success of therapy is development of a good abutment/soft-tissue seal. Sol-gel derived nanoporous TiO2 coatings have been shown to enhance soft-tissue attachment but their effect on adhesion and biofilm formation by oral bacteria is unknown.
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| 5. |
- Fröjd, Victoria, 1986, et al.
(författare)
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In situ analysis of multispecies biofilm formation on customized titanium surfaces
- 2011
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Ingår i: Molecular Oral Microbiology. - : John Wiley & Sons. - 2041-1006 .- 2041-1014. ; 26:4, s. 241-252
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Tidskriftsartikel (refereegranskat)abstract
- Many studies to identify surfaces that enhance the incorporation of dental implants into bone and soft-tissue have been undertaken previously. However, to succeed in the clinical situation, an implant surface must not support development of microbial biofilms with a pathogenic potential. As a first step in investigating this, we used two-species and three-species biofilm models with 16S ribosomal RNA fluorescence in situ hybridization and confocal laser scanning microscopy to examine the effect of surface characteristics on biofilm formation by species that can colonize titanium implants in vivo: Streptococcus sanguinis, Actinomyces naeslundii and Lactobacillus salivarius. Surfaces blasted with Al(2) O(3) (S(a) = 1.0-2.0 μm) showed a seven-fold higher bacterial adhesion after 2 h than turned surfaces (S(a) = 0.18 μm) whereas porous surfaces, generated by anodic oxidation (S(a) = 0.4 μm), showed four-fold greater adhesion than turned surfaces. Hence, increased roughness promoted adhesion, most likely through protection of bacteria from shear forces. Chemical modification of the blasted and oxidized surfaces by incorporation of Ca(2+) ions reduced adhesion compared with the corresponding non-modified surfaces. After 14 h, biofilm growth occurred in the three-species model but not in the two-species consortium (containing S. sanguinis and A. naeslundii only). The biofilm biovolume on all surfaces was similar, suggesting that the influence of surface characteristics on adhesion was compensated for by biofilm development.
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| 6. |
- Löfstrand, Jonas, 1981, et al.
(författare)
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Quality of Life after Free Fibula Flap Reconstruction of Segmental Mandibular Defects.
- 2018
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Ingår i: Journal of reconstructive microsurgery. - : Georg Thieme Verlag KG. - 1098-8947 .- 0743-684X. ; 34:2, s. 108-120
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundFree fibula flap (FFF) is considered gold standard in the reconstruction of mandibular defects. Despite the frequent use, patients' quality of life (QoL) after reconstruction has been sparsely investigated. This study aims to evaluate QoL and outcomes in patients who have undergone FFF reconstruction of segmental mandibular defects. MethodsA retrospective cohort study of consecutive patients (n=73) operated at a single center during the years 2000 to 2014 was performed. Charts were reviewed and all living patients (n=41) were invited to fill out three quality of life questionnaires (QLQ): SF-36, EORTC QLQ-C30, and QLQ-H&N35. Factors associated with poor outcome were derived from regression models and the results of the QLQs were compared with Swedish reference populations. Subgroup analysis was performed for two groups depending on reconstructive indication: cancer and osteoradionecrosis (ORN). ResultsThe response rate of the QLQs was 93%. General QoL did not differ from reference populations, but the study group had significantly larger proportions of poor functioning patients in three domains in EORTC QLQ-C30: global health status, role functioning, and social functioning. Patients also reported a high incidence of poor functioning/high symptom burden in EORTC QLQ-H&N35, with a significantly higher frequency in the ORN group compared with the cancer group for the domains “swallowing” and “social eating.” The overall flap success rate was 92% and complication rate was 48%. Previous surgery had a significant association with reoperation due to bleeding, and longer duration of surgery was significantly associated with local infection. ConclusionWhen evaluated with validated QLQs, most patients experienced persistent functional loss in one or several domains, but still perceived a general QoL that is close to that of reference populations. Patients having ORN as the indication for surgery, as compared with cancer, reported a higher frequency of poor functioning patients in disease-specific QoL domains.
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| 7. |
- Perrotta, Sossio, 1975, et al.
(författare)
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Surgical Treatment for Infective Endocarditis: A Single-Centre Experience.
- 2017
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Ingår i: The Thoracic and cardiovascular surgeon. - : Georg Thieme Verlag KG. - 1439-1902 .- 0171-6425. ; 65:3, s. 166-173
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveA considerable proportion of patients with acute infective endocarditis require surgical treatment. The aim of this study was to collate our short- and medium-term results of surgical treatment of infective endocarditis and to compare the results in native and prosthetic endocarditis. DesignTotal 254 operations for infective endocarditis from January 2008 to May 2015 were included in this retrospective study. There were 182 operations for native valve endocarditis and 72 for prosthetic valve endocarditis. Patient characteristics, operative details, complications, and mortality were registered. ResultsThe endocarditis was left sided in 247 operations (146 aortic, 78 mitral, and 23 double-valve) and right-sided in 7 (5 tricuspid and 2 pulmonary). Twenty-two patients (8.7%) died within 30 days (7.7% with native valve endocarditis and 11.1% with prosthetic valve endocarditis, p=0.31). Severe perioperative complications occurred in 99 of 254 operations (39%). Overall cumulative survival at 1 and 5 years was 86% and 75%, respectively, and it was not significantly different for native and prosthetic endocarditis (p=0.31). Eighteen patients (8%) had one (n=16) or two (n=2) recurrent episodes of endocarditis requiring surgery. ConclusionSurgery for infective endocarditis is still associated with a high early mortality rate and a considerable complication rate. Long-term outcome is acceptable. In our study population, morbidity and mortality were not significantly different in native and prosthetic endocarditis.
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| 8. |
- Perrotta, Sossio, 1975, et al.
(författare)
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Surgical treatment for isolated mitral valve endocarditis: a 16-year single-centre experience
- 2018
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 53:3, s. 576-581
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Tidskriftsartikel (refereegranskat)abstract
- Despite progress in management, mitral valve endocarditis (MVE) is still a life-threatening disease. We report our experience in surgical treatment of infective isolated MVE. A total of 140 operations in 128 patients for MVE performed between January 2000 and December 2015 were included in a retrospective study. There were 109 (78%) operations for native and 31 (22%) operations for prosthetic valve endocarditis. Preoperative and postoperative characteristics and mortality of patients were registered. Cox regression identified factors associated with mortality. Mean follow-up period was 68 months (range 1-168 months) and 100% complete. There were 13 deaths within 30 days after the 140 operations (9%). Severe perioperative complications occurred in 59 (42%) operations. Overall cumulative survival was 73% +/- 4 at 5 years and 62 +/- 5% at 10 years after the first operation. Age, diabetes, EuroSCORE II and perivalvular abscess were independent predictors for long-term mortality. Valve repair was performed in 76 (54%) operations and replacement in 64 (46%) operations. Thirty-day mortality for repair was 1%, and 5-year and 10-year cumulative survival was 86 +/- 4% and 77 +/- 6%, respectively. In the replacement group the 30-day mortality was 19% and cumulative survival at 5 years and 10 years was 55 +/- 7% and 41 +/- 8%, respectively. Postoperative complications occurred in 21% and 67%, respectively, after operations for repair and replacement. Ten (8%) patients had 12 reoperations for recurrent endocarditis. MVE requiring surgical treatment is a challenging disease with high hospital mortality after valve replacement. Mitral valve repair can be performed in suitable endocarditis patients with excellent results. Age, diabetes and EuroSCORE were independently associated with mortality in a multivariable model.
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| 9. |
- Perrotta, Sossio, 1975, et al.
(författare)
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Surgical Treatment of Aortic Prosthetic Valve Endocarditis: A 20-Year Single-Center Experience.
- 2016
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Ingår i: The Annals of thoracic surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 101:4, s. 1426-1432
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Tidskriftsartikel (refereegranskat)abstract
- Despite progress in diagnostic methods and treatment, aortic prosthetic valve endocarditis (PVE) remains a life-threatening disease. We report the outcome of all operations for aortic PVE performed at our institution over the past 20 years.
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| 10. |
- Revesz, David, et al.
(författare)
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Estimating Long-Term Vagus Nerve Stimulation Effectiveness: Accounting for Antiepileptic Drug Treatment Changes
- 2018
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Ingår i: Neuromodulation. - : Elsevier BV. - 1094-7159. ; 21:8, s. 797-804
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the effectiveness of vagus nerve stimulation (VNS) in combination with pharmacological therapy in a longitudinal retrospective study at a single center. Materials and Methods Data from 130 consecutive patients implanted with a VNS device between the years 2000 and 2013 was analyzed. Seizure frequency and pharmacological antiepileptic drug (AED) treatments were recorded prior to as well as at one, two, and five years after VNS implantation. Results Median age at epilepsy onset was five years and mean years from diagnosis to VNS implantation was 16.5 years. There was a significant seizure reduction overall (all p < 0.001). The responder (>= 50% seizure frequency reduction) rate increased from 22.1 to 43.8% between the first and fifth year for the cohort as a whole, with the largest increase between the first and second year (22.1-38.1%) and regardless of AED changes. VNS effectiveness did not differ between patients who altered or remained on the same AEDs. Patients were treated with a median of three AEDs throughout the study and the number of AEDs significantly increased after two (p = 0.007) and five (p = 0.001) years. Conclusions VNS is a well-tolerated palliative neuromodulatory treatment for drug resistant epilepsy with a 43.8% seizure reduction after five years. Our data supports the idea that VNS effectiveness increases with time. Therefore we suggest that VNS should be evaluated for at least two years after implantation. AED changes should try to be kept to a minimum during evaluation in order to determine the effectiveness of VNS.
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