| 1. |
- Holgers, K M, et al.
(author)
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Clinical, immunological and bacteriological evaluation of adverse reactions to skin-penetrating titanium implants in the head and neck region
- 1992
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In: Contact Dermatitis. - : Wiley. - 0105-1873. ; 27:1, s. 1-7
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Journal article (peer-reviewed)abstract
- Between 1977 and October 1989, 445 patients have been treated with bone-anchored skin-penetrating titanium implants for anchorage of facial prostheses or bone-conducting hearing aids, at the Ear, Nose and Throat Department at Sahlgren's Hospital in Gothenburg. The majority of patients had no adverse skin reactions, while a few patients were responsible for the majority of the adverse reactions. The aim of our study was to analyse differences between these groups. We started a clinical study on 9 patients with a clinical history of adverse skin reactions around the titanium implants and 9 patients without adverse skin reactions were used as controls. None of the patients had delayed hypersensitivity to titanium. Microbiological analyses showed that when there was clinical irritation, Staphylococcus aureus could be isolated.
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| 2. |
- Holgers, K M, et al.
(author)
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Immunohistochemical study of the soft tissue around long-term skin-penetrating titanium implants
- 1995
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In: Biomaterials. - 1878-5905. ; 16:8, s. 611-616
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Journal article (peer-reviewed)abstract
- Bone-anchored percutaneous titanium implants have become a well-established clinical procedure with a low incidence of adverse reactions. However, passage through the skin leads to a breach in the barrier to exogenous pathogens. In the present study, monoclonal antibodies were used to investigate the distribution of lymphocyte subpopulations in the soft tissue around such implants. Eight biopsies from patients with clinically irritated skin, five from non-irritated and eight from skin without skin-penetrating implants were analysed. The number of immune cells was increased in the group of patients with skin penetration compared with patients without skin penetration. In the group with clinical irritation there was an increased level of B-lymphocytes compared with those without irritation. The data suggest that there is an immunological compensation for the mechanical loss in barrier function at these implants and that an antibody-mediated response is present at clinical signs of irritation.
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| 3. |
- Holgers, K M, et al.
(author)
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Soft tissue reactions around percutaneous implants: a clinical study of soft tissue conditions around skin-penetrating titanium implants for bone-anchored hearing aids
- 1988
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In: American Journal of Otology. - 0192-9763. ; 9:1, s. 56-59
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Journal article (peer-reviewed)abstract
- Some patients with hearing impairment cannot use conventional hearing aids. One solution for these patients is the use of bone conduction hearing aids; however, this kind of equipment is associated with several problems related to the necessity for a good contact between the transducer and the temporal bone. Direct bone contact would be an ideal solution provided that safe and reaction-free skin penetration and a safe and permanent bone anchorage could be achieved. Branemark et al have developed a procedure to furnish edentulous patients with fixed bridges using titanium implants. This report is focused on the clinical status of the soft tissue adjacent to the 67 skin-penetrating devices in 60 patients. The patients have been followed between 3 and 96 months on 313 occasions, which represents a total observation time of 1515 months of clinical performance. Only one implant was extracted due to adverse skin reaction, giving a failure rate of 0.07% per month. This is comparable with the failure rate of cardiac pacemakers 0.02-0.04% per month).
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