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Biomedical subjects

Ulrich Meyer

Publications and source records attributed to Ulrich Meyer.

At least 19 recordsLinked to original sources
PubMed2007

Prospects of micromass culture technology in tissue engineering.

Tissue engineering of bone and cartilage tissue for subsequent implantation is of growing interest in cranio- and maxillofacial surgery. Commonly it is performed by using cells coaxed with scaffolds. Recently, there is a controversy concerning the use of artificial scaffolds compared to the use of a natural matrix. Therefore, new approaches called micromass technology have been invented to overcome these problems by avoiding the need for scaffolds. Technically, cells are dissociated and the dispersed cells are then reaggregated into cellular spheres. The micromass technology approach enables investigators to follow tissue formation from single cell sources to organised spheres in a controlled environment. Thus, the inherent fundamentals of tissue engineering are better revealed. Additionally, as the newly formed tissue is devoid of an artificial material, it resembles more closely the in vivo situation. The purpose of this review is to provide an insight into the fundamentals and the technique of micromass cell culture used to study bone tissue engineering.

Animals↗
PubMed2007

Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skeletal class-III conditions: review of the literature and report of a case.

BACKGROUND: Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. METHODS: Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skeletal class-III conditions due to cleft palate are described. RESULTS: A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. CONCLUSION: Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

Alveolar Bone Loss↗
PubMed2006

Treatment of hemimandibular hyperplasia: the biological basis of condylectomy.

Treatments to correct skeletal deformities in patients with hemimandibular hyperplasia differ, particularly about the age at which the operation is done and the operation itself. To some extent, the differences can be attributed to the unknown biological basis of disease. The aim of the present study was to evaluate clinically the outcome of a rationale for the operation based on condylectomy on the affected side. Histological, radiological, and nuclear methods were used to get a more detailed insight into the reason for the operation. Six patients with hemimandibular hyperplasia were treated by a combined orthodontic-maxillofacial protocol. All patients had the affected joint removed. The histological morphology of each condylar specimen was compared with the bone scintigraphy to try and find a correlation between the methods. The clinical evaluation showed morphological and functional rehabilitation of all six patients. During the 2-year follow-up, all patients had stable symmetrical mandibles with no disturbance of temporomandibular function. Remodelling of the joint and the destruction of the cartilaginous layer was accompanied by much bone scintigraphic activity. We conclude that condylectomy can correct hemimandibular hyperplasia, even in patients with active condylar growth, by removing the underlying disease.

Adult↗
PubMed2006

New paradigm in implant osseointegration.

During the last years, implant dentistry has seen an dramatic increase as a treatment option in oral rehabilitation. This is based to a large extent on scientific advances and clinical improvements in implantology. The extension of indications has broadened the opportunities to rehabilitate patients that were formerly considered to possess restricted indications to place implants. Additionally, patient desires (high aesthetic demands, fast prosthetic rehabilitation) were placed more in focus, resulting in new approaches in implant dentistry. As a result, the scientific and clinical community has reached high standards and at the same time has founded the basis for new opportunities in implantology. The advances are mirrored by a high number of high quality scientific papers, published in conventional and open-access journals. A major shift has thereby been observed in the understanding of implant healing, leading the basis for new implant systems that allow fast rehabilitation protocols. The term osseointegration needs a new understanding since an immediate osseointegration state can be present under distinct conditions.

Dental Implantation, Endosseous↗
PubMed2006

Biological and biomechanical evaluation of interface reaction at conical screw-type implants.

BACKGROUND: Initial stability of the implant is, in effect, one of the fundamental criteria for obtaining long-term osseointegration. Achieving implant stability depends on the implant-bone relation, the surgical technique and on the microscopic and macroscopic morphology of the implant used. A newly designed parabolic screw-type dental implant system was tested in vivo for early stages of interface reaction at the implant surface. METHODS: A total of 40 implants were placed into the cranial and caudal part of the tibia in eight male Göttinger minipigs. Resonance frequency measurements (RFM) were made on each implant at the time of fixture placement, 7 days and 28 days thereafter in all animals. Block biopsies were harvested 7 and 28 days (four animals each) following surgery. Biomechanical testing, removable torque tests (RTV), resonance frequency analysis; histological and histomorphometric analysis as well as ultrastructural investigations (scanning electron microscopy (SEM)) were performed. RESULTS: Implant stability in respect to the measured RTV and RFM-levels were found to be high after 7 days of implants osseointegration and remained at this level during the experimented course. Additionally, RFM level demonstrated no alteration towards baseline levels during the osseointegration. No significant increase or decrease in the mean RFM (6029 Hz; 6256 Hz and 5885 Hz after 0-, 7- and 28 days) were observed. The removal torque values show after 7 and 28 days no significant difference. SEM analysis demonstrated a direct bone to implant contact over the whole implant surface. The bone-to-implant contact ratio increased from 35.8 +/- 7.2% to 46.3 +/- 17.7% over time (p = 0,146). CONCLUSION: The results of this study indicate primary stability of implants which osseointegrated with an intimate bone contact over the whole length of the implant.

Journal Article↗
PubMed2006

Fast element mapping of titanium wear around implants of different surface structures.

The effect of unintended titanium release around oral implants remains a biological concern. The current study was undertaken to evaluate a new detection system of element mapping in biological probes. A new scanning electron microscopy-energy dispersive spectroscopy detection method was used to map the features of titanium contamination in peri-implant bone around implants with different surface structures. The amount of titanium wear was highest adjacent to titanium-plasma-sprayed surfaces, followed by sandblastered large grid acid-etched and smooth surfaces. A high sensitivity of titanium detection over large areas of bone tissue was observed. A high spatial resolution of titanium wear particles (20 nm) could be reached and correlated to the ultrastructural morphological features of peri-implant tissue. Cells adjacent to titanium wear revealed no signs of morphological alterations on a nanoscale level at early periods of implant/bone interaction. The new technique may serve as a fast and effective tool to evaluate titanium release effects in biological probes.

Acid Etching, Dental↗
PubMed2006

Load-related bone modelling at the interface of orthodontic micro-implants.

The purpose of this study was to determine the interface reaction of two different titanium micro-implant systems activated with different load regimens. A total of 200 micro-implants (100 Abso Anchor and 100 Dual Top) were placed in the mandible of eight Göttinger minipigs. Two implants each were immediately loaded in the opposite direction by various forces (100, 300 or 500 cN) through tension coils. Three different distances between the neck of the implant and the bone rim (1, 2, 3 mm) were used. The loads provided by superelastic tension coils (which are known to develop a virtually constant force) led to a range of tip moments 0-900 cN mm at the neck of implants. Non-loaded implants were used as a reference. Bone tissue responses were evaluated by histology, histomorphometry and scanning electron microscopy after 22 and 70 days of loading. Implant loosening was present in the groups where the load reached 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any of the applied loads. A direct bone-to-implant contact to various extents was observed at differently loaded implants. Ultrastructural analysis confirmed the clinical and histological finding that implants (except when loaded at 900 cN mm) were well osseointegrated after 22 days. An increase in the bone-to-implant contact ratio was observed during the experimental period in the coronal part of the implants in most experimental groups. The difference reached a level of statistical significance at 500 cN mm (Abso Anchor) and 600 cN mm (Dual Top). We conclude that micro-implants can not only be loaded immediately without impairment of implant stability but many enhance bone formation at the interface when the load-related biomechanics do not exceed an upper limit of tip moment at the bone rim.

Animals↗
PubMed2005

Strain driven fast osseointegration of implants.

BACKGROUND: Although the bone's capability of dental implant osseointegration has clinically been utilised as early as in the Gallo-Roman population, the specific mechanisms for the emergence and maintenance of peri-implant bone under functional load have not been identified. Here we show that under immediate loading of specially designed dental implants with masticatory loads, osseointegration is rapidly achieved. METHODS: We examined the bone reaction around non- and immediately loaded dental implants inserted in the mandible of mature minipigs during the presently assumed time for osseointegration. We used threaded conical titanium implants containing a titanium2+ oxide surface, allowing direct bone contact after insertion. The external geometry was designed according to finite element analysis: the calculation showed that physiological amplitudes of strain (500-3,000 ustrain) generated through mastication were homogenously distributed in peri-implant bone. The strain-energy density (SED) rate under assessment of a 1 Hz loading cycle was 150 Jm-3 s-1, peak dislocations were lower then nm. RESULTS: Bone was in direct contact to the implant surface (bone/implant contact rate 90%) from day one of implant insertion, as quantified by undecalcified histological sections. This effect was substantiated by ultrastructural analysis of intimate osteoblast attachment and mature collagen mineralisation at the titanium surface. We detected no loss in the intimate bone/implant bond during the experimental period of either control or experimental animals, indicating that immediate load had no adverse effect on bone structure in peri-implant bone. CONCLUSION: In terms of clinical relevance, the load related bone reaction at the implant interface may in combination with substrate effects be responsible for an immediate osseointegration state.

Dental Implants↗
PubMed2005

Objective growth monitoring of the maxilla in full term infants.

OBJECTIVE: To develop a non-invasive method for longitudinal maxillary volume measurements and to provide first normative data. DESIGN: Thirty-four healthy infants served as a gold standard for a growing population sample. Alginate impressions were taken of the upper jaw within the first week after birth, and consecutively at different stages of development. The plaster casts were digitised by an optical scanner generating a high resolution polygon mesh of each object. The digital models were aligned to a reference coordinate system with an iterative, landmark-independent procedure. Biometric linear and volume measurements were obtained by using feature-dependent calculations independent of landmark placements. Intra-investigator reproducibility was tested by repeated alignments and measurements of 30 randomly selected casts. To assess the effect of mesh resolution, the reproducibility test was repeated with low resolution models. The method was proved to be valid on the defined gold standard consisting of 96 consecutive edentulous casts. RESULTS: Feature-dependent, linear distances are less error prone (0.56-2.66%) compared to subjectively determined measurements (0.88-3.65%). The same applies to feature-dependent volume calculations (4.34%) compared to subjectively determined volumes (4.95%). Mesh resolution shows an effect (p<or=0.001) only on two linear measurements: palatal depth and palatal length. Growth of the individuals in the population sample was evidently confirmed by the maxillary volume measurements (asymptotic pattern) and by comparisons of head circumference (proportional pattern). CONCLUSION: The described method is non-invasive, precise and without any risk for the infant. Maxillary volume calculation could serve as an important biometric measurement for bone growth evaluation.

Biometry↗
PubMed2005

Tissue engineering: a challenge of today's medicine.

During the last years, tissue engineering-based therapies have been introduced in clinical practice in the head and face area. The regeneration of complex tissue structures for all sites of the body is envisioned for the future. In the present situation, specialists of the different fields publish excellent research papers in specialised journals. As a result, the scientific community, separated towards distinct sub-specialities, has difficulties in communication. To overcome this problem, the demanding, complex and interdisciplinary aspects of tissue engineering has to be approached from new ways. We have conceptualised Head & Face Medicine therefore as a thematically broad ranged journal, including all disciplines involved in the head and neck area. We hope this journal will attract basic researchers and clinicians who are involved in investigating and applying complex themes (examplified by tissue engineering) in the head and face region and will contribute to a gain in scientific information, communication, and collaboration in order to improve the outcome of patient treatments.

Biomedical Research↗
PubMed2005

Potential and limitations of cephalometric analysis of maxillofacial bone movement in the case of LeFort III-distraction.

BACKGROUND AND METHOD: The treatment of craniofacial deformities by means of distraction osteogenesis has become an established therapeutic procedure. Evaluation of the success of an operation is usually carried out via conventional cephalometry. Conventional forms of analysis seem problematic due to surgically-induced changes in the skull base. In this study we investigated the movement of the midface in the presence of a syndromerelated surgical indication employing two different types of analysis, namely those of Ricketts and Delaire. RESULTS: It seems that neither procedure is suitable for determining this type of bone movement conclusively. Comparing the two, the Delaire analysis possessed greater informative value in view of the altered geometry, and a combination of both procedures made more exact determination possible of the final position achieved.

Adolescent↗
PubMed2005

Osteoblast alignment, elongation and migration on grooved polystyrene surfaces patterned by Langmuir-Blodgett lithography.

Topographically patterned surfaces are known to influence cellular behavior in a controllable manner. However, the relatively large surface areas (several cm2) required for many biomaterial applications are beyond the practical limits of traditional lithography. Langmuir-Blodgett lithography, a recently developed method, was used to fabricate regularly spaced grooves of different depths (50 and 150 nm) with a periodicity of 500 nm over several square centimeter on silicon surfaces. These topographies were transferred into polystyrene surfaces by means of nanoimprinting. Primary osteoblasts were cultured on the patterned polymer surfaces. They were observed to align, elongate and migrate parallel to the grooves. The combination of Langmuir-Blodgett lithography with nanoimprinting enables the fabrication of large, nanostructured surface areas on a wide spectrum of different biomaterials. Osteoblasts show a significant anisotropic behavior to these surfaces, which can enhance cell settlement on the surface or be used to direct tissue generation on the biomaterial interface.

Actinin↗
PubMed2005

Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique.

The influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animal model. A total of 56 implants were placed in the cranial and caudal tibia condyle of six Gottinger minipigs. The implant site was prepared either by the conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and at the time of scarification. Half of the minipigs were sacrificed 7 days and 28 days after implant placement and the implants were removed with the surrounding bone. Bone tissue responses were evaluated by histological analysis and removal torque testing. For histological evaluation 30-50 microm-thick ground sections were examined. Biomechanical testing revealed a significantly higher stability of implants in the control group (A) than in the experimental group (B) (P = 0.004) at day 7. After 28 days implant stability in the control group remained significant higher (47%) than those of group B (P > 0.001). RFM demonstrated no significant difference between both groups and during the experimental course. Histological analysis demonstrated fractured trabeculae in peri-implant bone in the experimental group at day 7, while they were not posed at day 28. We conclude that the decreased implant stability by using the osteotome technique is based on microfractures in peri-implant bone.

Animals↗
PubMed2005

Interface reaction at dental implants inserted in condensed bone.

PURPOSE: The influence of the osteotome technique on the interface reaction of cylinder implants (SLA, ITI) was compared with the interface reaction of conventional implant insertion in an animal model. MATERIAL AND METHODS: A total of 64 implants were placed in the cranial and caudal tibia of 8 Göttinger minipigs. The implant site was prepared either by a conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Bone tissue responses were evaluated by histomorphometry, fluorescence microscopy and scanning electron microscopy after 7 and 28 days of osseointegration. RESULTS: The average initial (7 days) bone-to-implant contact ratio was not statistically significantly different for the osteotome technique (35.88+/-2.94%) than for the control group (43.78+/-3.39%, P<0.095). After 28 days, the bone-to-implant contact ratio became statistically significantly higher when implants were inserted by conventional preparation (44.81+/-3.07% (group B), 63.47+/-4.87% (group A), P=0.003). Whereas fluorescence and immunhistologic examination revealed new bone formation with osteocalcin deposition directly at the implant surface in both groups, the extent of direct bone/implant contact was enhanced in conventionally prepared implant sites. SEM analysis confirmed an intimate bone to implant bond without fibrous tissue formation in places of direct contact at an ultrastructured level. CONCLUSION: Implant placement in conventionally prepared implantation sites is accompanied by an improved interface formation at an early stage of implantation.

Animals↗
PubMed2005

Load-related implant reaction of mini-implants used for orthodontic anchorage.

The purpose of this study was to determine the clinical and biomechanical outcome of two different titanium mini-implant systems activated with different load regimens. A total of 200 mini-implants (102 Abso Anchor and 98 Dual Top) were placed in the mandible of eight Göttinger minipigs. Two implants each were immediately loaded in opposite direction by various forces (100, 300 or 500 cN) through tension coils. Additionally, three different distances between the neck of the implant and the bone rim (1, 2 and 3 mm) were used. The different load protocols were chosen to evaluate the load-related implant performance. The load was provided by superelastic tension coils, which are known to develop a virtually constant force. Non-loaded implants were used as a reference. Following an experimental loading period of 22 and 70 days half of the minipigs were sacrificed, and implant containing bone specimens evaluated for clinical performance and implant stability. Implant loosing was found to be statistically dependent on the tip moment (TM) at the bone rim. Clinical implant loosing were only present when load exceeded 900 cN mm. No movement of implants through the bone was found in the experimental groups, for any applied loads. Over the two experimental periods the non-loaded implants of one type of implant had a higher stability than those of the loaded implants. Dual Top implants revealed a slightly higher removal torque compared with Abso Anchor implants. Based on the results of this study, immediate loading of mini-implants can be performed without loss of stability when the load-related biomechanics do not exceed an upper limit of TM at the bone rim.

Animals↗
PubMed2005

Histologic, histomorphometric and immunohistologic changes of the gingival tissues immediately following mandibular osteodistraction.

OBJECTIVES: Even though osteogenesis after osteodistraction has been investigated in numerous experimental studies, there is limited information focusing on the influence of well-defined mechanical distraction forces on the associated gingival tissues. MATERIAL AND METHODS: In a study including 48 rabbits, mandibular osteodistraction was performed in vertically osteotomized mandibular body, using defined distraction protocols with physiologic, moderate and hyperphysiologic forces. The soft tissues overlying the distraction gap were harvested finally for histologic, immunohistologic and histomorphometric investigations. RESULTS: The control group without distraction showed the typical architecture and thickness of normal gingiva. In groups with distracted mandibles, an accelerating atrophy of gingiva depending on the degree of mechanical loading was obvious, characterized by decreasing thickness of epithelial layer, loss of rete ridges and disorganization of the different cell layers with a high number of apoptotic cells. In lamina propria collagen fibres were reduced and elastic fibres increased. Histomorphometric analysis revealed significant correlation between degree of distraction and atrophy in overlying soft tissues. CONCLUSION: This rabbit model of mandibular lengthening shows an accelerating atrophy in the covering soft tissues following hyperphysiologic distraction. The long-term outcome of these distraction-related soft-tissue alterations remains unclear. The atrophic changes may likely be of temporary nature.

Animals↗