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Unit Thirty The Surgical Principles of Osseointegration Ragnar Adell

论文作者:佚名论文属性:短文 essay登出时间:2009-12-14编辑:lisa点击率:10470

论文字数:200论文编号:org200912140958398956语种:英语论文 English地区:中国价格:免费论文

关键词:

   Osseointegration; process and definition.
     The possibility of permanently retaining titanium fixture in vital remodeling bone with a capacity of considerable load bearing depends on an adequate comprehension of the osseointegration process. Professor Per-Ingvar Branemark coined Osseointigration as a term in the early 1970s. Its current definition-a direct contact between living, haversian bone and the loaded implant surface-is based on histological and ultrastructural observations but is not yet fully defined.
     However, it is well supported by long-term radiographic and clinical studies demonstrating perifixtural bone adaption and remodeling as well as long-term fixture stability and load-bearing capacity.
     There is no instant osseointegration. Its gradual and slow development must be fully understood in order for a successful clinical outcome to be achieved.
     Achieving osseointegation
     The mere use of titanium as an implant material is by no means any guarantee of achieving osseointegration. Managing the host organism and tissues should attract at least as much interest as the properties and handling of the implant.
     Preoperative host factors
     General patient conditions
     No investigations so far have been undertaken systematically to evaluate the influence of diseases, medications, and drugs that may theoretically affect wound healing-especially bone healing and remodeling-after installation of titanium fixtures. Several such patient preconditions could be considered:
     l. Age
     2. Sex (due to postmenopausal osteoporosis)
     3. Malabsorption syndromes (eg, ulcerative colitis)
     4. Bone metabolic diseases (eg, osteoporosis, osteomalacia, gyperparathyroidism, Paget' s
      disease)
     5. Rheumatic diseases (eg, rheumatoid arthritis, Sjogren' s syndrome, systemic lupus
       erythematosus)
     6. Hormonal diseases (eg, diabetes, Cushing' s syndrome, gyperparathyroidism)
     7. Coagulation disorders and anticoagulation medications
     8. Systemic treatment with glucocorticoides
     9. Alcohol abuse
     10. Tobacco smoking
     Studies have initially indicated that a higher chronological patient age alone is not a determining factor for the outcome of treatment with fixtures, whereas tobacco smoking maybe. So far, there is insufficient evidence to support the installation of fixtures in growing jaws. Experimental studies and a few clinical trials indicate that the fixtures may not move with increasing vertical height of the jaw. Rheumatoid arthritis is not regarded as a contraindication for the use of osseointegrated implants in orthopedic surgery.
     Among the more than 35,000 patients the world over who have been treated with implant fixtures, a number are known to be medically compromised by one or several of the factors listed above with little or no influence on the treatment outcome. This especially applies to postmenopausal osteoporosis. Women are very论文英语论文网提供整理,提供论文代写英语论文代写代写论文代写英语论文代写留学生论文代写英文论文留学生论文代写相关核心关键词搜索。

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