theranostics or personalized medicine or precision medicine is a medical model that separates people into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease. The terms personalized medicine, precision medicine, stratified medicine and P4 medicine are used interchangeably to describe this concept though some authors …
A bridge therapy means to bridge to another stage of therapy or health. There are various types of bridge therapies: Bridge to transplant Bridge to candidacy Bridge to decision Bridge to recovery Anticoagulation bridge Opposite: Destination therapy
extracorporeal life support
Tissue surgically removed from one area of a person’s body and transplanted in another site on the same person.
Organoids are multicellular structures that can be derived from adult organs or pluripotent stem cells. Early versions of organoids range from simple epithelial structures to complex, disorganized tissues with large cellular diversity.
CleanImplant checks the quality of dental implants by the purity of the implant surfaces.
Acellular Dermal Matrix
operation free period
= Critical Incident Technique see also CIRS
= Critical Incident Reporting-System The Critical Incident Technique (or CIT) is a set of procedures used for collecting direct observations of human behavior that have critical significance and meet methodically defined criteria. These observations are then kept track of as incidents, which are then used to solve practical problems and develop broad psychological principles. A critical …
There are different classifications of bone density (quality) in oral implantology. Lekholm U, Zarb GA: Patient selection and preparation. In: Brånemark PI, Zarb GA, Albrektsson T. Tissue integrated Prostheses: Osseointegration in Clincal Dentistry. Chicago: Quintessence Publishing Co. Inc.; 1985:199-209. Bone Density/Quality Types I: Almost the entire jaw is comprised of homogenous compact bone. II: …
see: Modulus of elasticity
A principle stating that bone will develop the structure most suited to resist those forces acting on it.
The process of infiltration of blood vessels; regarded as a critical support for the health and maintenance of living tissue or the integration of a graft.
An opening in an implant body that allows for tissue ingrowth for increased retention and stability.
Commonly used statistical method to evaluate the differences in means between two groups.
The placement of three or more implants with a non-linear alignment of their platform.
Syn.: TGF-β Transforming growth factor beta is a multifunctional cytokine belonging to the transforming growth factor superfamily. It activates different downstream substrates and regulatory proteins, inducing transcription of different target genes that function in differentiation, chemotaxis, proliferation, and activation of many immune cells. Among its key functions is regulation of inflammatory processes, particularly in the gut. …
see: Transforming growth factor beta
A force that produces or tends to produce rotation or torsion. A measurement of an instrument capacity to do work or to continue to rotate under resistance to rotation. It is expressed in Newtons centimeter (Ncm).
Surface layer of varying surface composition (e.g. TiO2, TiO4) immediately formed upon exposure of pure metallic titanium and titanium alloy to air. This corrosion-resistant layer protects the implant against chemical attack in biological fluids. Metal oxide blasted on implant surfaces to increase the surface area.
Tissue engineering works with cells, engineering and materials methods, and suitable biochemical and physicochemical factors to improve or replace biological tissues.
A laboratory specialized in the harvesting, processing, and sterilization of tissues from humans or animals.
An dental endosseous implant that is inserted laterally, from the facial aspect of the edentulous alveolar ridge.
Number of threads per unit length in the same axial plane.
An extruding feature of the body of threaded implants. Geometric parameters: Thread depth, thickness, pitch, face angle, helix angle. Basic thread geometries include: V-thread, buttress thread, and power (square) thread.
Stress caused by a load (two forces applied away from one another in the same straight line) that tends to stretch or elongate an object.
A three-dimensional roughness parameter calculated from topographical images. Sa: The arithmetic average of the absolute value of all points of the profile, it is a height descriptive parameter. Scx: A space descriptive parameter. Sdr: The developed surface area ratio.
The topography of an implant surface is defined in terms of form, waviness and roughness. Roughness describes the smallest irregularities in the surface, while form relates to the largest structure or profile. Waviness and roughness are often presented together under the term texture.
The percentage of success of a procedure or device in a study or clinical trial according to success criteria defined by the study protocol.
Conditions established by a study protocol for the evaluation of a procedure as a success.
Undifferentiated cell of embryogenic or adult origin that can undergo unlimited division and give rise to one or several different cell types.
Acro.: SD Statistical term. A measure of the variability, or dispersion of a distribution of scores. The more scores cluster around the mean, the smaller the standard deviation.
Inflammation of the sinus maxillaris. Signs include sensitivity of teeth to percussion, fever, and facial swelling. Symptoms may include nasal congestion, post nasal discharge, facial pain, headache, rhinorrhea, halitosis, popping of ears, and muffled hearing. It may occur with oral surgery combined with dental implants or augmentation (sinus elevation, sinuslift).
Heating a powder below the melting point of any component so as to permit agglomeration and welding of particles by diffusion alone, with or without applied pressure.
Stress caused by a load (two forces applied toward one another but not in the same straight line) that tends to slide one portion of object ove another.
see: Late implant failure
Syn.: Secondary implant failure Failure of an implant after integration has been established. This maybe due to overload or periimplantitis.
Syn.: Healing by secondary intention, secondary closure. Healing of a wound in which a gap is left between its edges. Union or restoration occurs by granulation tissue formation from the base and sides. This requires a large amount of epithelial migration, collagen deposition, contraction, and remodeling during healing. It may result in a scar or …
Syn.: Healing by primary intention, primary closure. Healing of a wound in which the edges are closely re-approximated. Union or restoration of continuity occurs directly with minimal granulation tissue and scar formation.
see: Healing by second intention
A 3D biocompatible construct that serves as a framework which provides a structure on which tissue is growing. It may be replaced by naturel tissue.
The excavation of tissue to form a shallow shelving depression, usually performed to facilitate drainage from infected areas of bone. The shallow saucer-like depression on the upper surface of a vertebra that has suffered a compression fracture. Dental: Pericervical depression around an dental implants neck.
Grit blasting of an implant surface using sand to increase the surface.
A two-dimensional roughness parameter calculated from the experimental profiles after filtering. Ra: The arithmetic average of the absolute value of all points of the profile, also called central line average height Rt: The maximum peak-to-valley height of the entire measurement trace.
Test used to assess the extent of osseointegration of an implant, specifically the shear strength at the bone-implant interface, by applying a rotational force in a direction opposite to that used to place the implant. Acro.: RTT
A study designed to observe events that have already occurred.
Loss of substance or bone by physiologic or pathologic means.
Immunological response of incompatibility in a transplanted or implanted material.
Probability that a test statistic will assume a value as extreme as or more extreme than that seen under the assumption that the null hypothesis is true.
Gradual increase in the application of load on an implant.
see: Regional acceleratory phenomenon
RAP A local response to a stimulus in which tissues form 2 to 10 times more rapidly than the normal regeneration process. The duration and intensity of RAP are directly proportional ton the kind and amount of stimulus and the site where it was produced.
The surgical reopening of a site to improve or observe results obtained from the initial procedure.
see Recombinant human bone morphogenetic protein
rhBMP Osteoinductive protein produced by recombinant DNA technology.
see: Transitional implant.
An undifferentiated cell that possesses the ability to transform into one or more types of cells.
see: Initial stability
Retention of a root-form implant from close proximity of the bone. Retention of certain components into an implant.
Term for inflammatory reactions surrounding a dental implant.
Graft consisting of particles.
Property of a material, that does not degrade over time.
Refers to forces applied off the implant long-axis.
Ratio of stress over strain., when the deformation is elastic. It is a measure of stiffness or flexibility of a material. A stiff material has a high modulus of elasticity and a flexible material ha s a low modulus of elasticity. Syn.: Young´s modulus
A quantitative method of combining the results of independent studies measuring specified protocol criteria (usually drawn from the published literature) and synthesizing summaries and conclusions that may be used to evaluate therapeutic effectiveness, and plan new studies.
Measure of central tendency. It is the middle score in a distribution or set of ranked scores. When the number of values in the sample is even, the median is computed as the average of the two middle values.
(arithmetic) Measure of central tendency that is calculated by adding all the individual values in the group and dividing by the number of values in the group.
An intricate network of natural or synthetic fibers that aids in the reinforcement and development of tissues by supplying a scaffold on which cells may grow, migrate and proliferate.
A study in which observations on the same subjects are made at two or more different points in time.
Statistical method to describe the survival (e. g. implants) in a sample. The distribution of survival times is divided into a certain number of intervals. For each interval, one can compute the number and proportion of cases that entered the respective interval “alive”, the number and proportion of cases that failed in the respective interval …
see: Isologous graft.
A tissue graft transplanted from one genetically identical individual to another, as in monozygotic twins. Syn.: Isogeneic graft, isologous graft, syngeneic graft, Isograft.
Within the living organism or natural system.
Outside of the living organism or natural system. Usually refers to artificial experimental systems such as cultures or cell-free extras.
Insulin-like growth factors
IGF Peptides that behave similarly to insulin and stimulate cell proliferation.
The torque value used to insert a screw-shaped implant into an osteotomy, expressed in Newtons centimeter.
The degree of tightness of an implant immediately after placement in the prepared osteotomy. An implant is considered to have initial stability if it is clinically immobile at time of placement.
Implant stability quotient
ISQ Measure of implant stability (from 1 to 100, 100 being the highest degree of stability) obtained from resonance frequency analysis
The area of contact between tissues (e. g. bone, connective tissue) and the implant surface
HU A unit of y-ray attenuation used for CT-scans as a measurement of bone density. Each pixel is assigned a value on a scale on which air is -1000, water 0, and compact bone +1000. In dentistry exists a proposal to use bone density as a determinant for clinical success (Misch CE, Contemporary Implant Dentistry, …
see: Recipient site.
Site which received a soft or hard tissue graft. Syn.: Host site.
The local or systemic response of the host organism to an implanted material or device.
A graft taken from one human subject and transplanted into another. Syn.: Homograft, homogenous graft.
see: Homologous graft
The quantitative study of the microscopic organization and structure of a tissue (e. g. bone), especially by computer-assisted analysis of images acquired from a microscope.
Any highly specific protein that stimulates the division and differentiation of particular types of cells.
Material or tissue used for implantation or transplantation.
State of retention of an implant at the time of insertion that results from slight compression of the osteotomy walls by the implant body. Components retained to an implant by friction.
Finite element analysis
A numerical method for solving problems of engineering and mathematical physics. Software technique used to study stresses and strains on mechanical parts or components. Virtual prototyping software, often a component of CAD software programs, automatically generates the simulated mechanical loads for FEA The finite element method formulation of the problem results in a system of …
A structural failure caused by multiple loading episodes when all loads lie below the structure´s ultimate strength.
Progressive weakening of a structure by accumulating embrittlement and crack formation/propagation.
The percentage of failures in a study or clinical trial, of a procedure or a device (e. g. implant), which do not meet the success criteria or fall into the failure criteria, defined in the study protocol.
The dehiscence of soft tissue exposing an implanted material.
Area of the body from which a graft is harvested. This can be skin, mucosa, connective tissue, and bone.
ISO develops International Standards, such as ISO 9001, but is not involved in their certification, and does not issue certificates. Certificates are performed by external certification bodies, thus a company or organization cannot be certified by ISO.
International Organization of Standardization ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body interested in a subject for which a technical committee has been established has the right to be …
ISO: A medical device is a product, such as an instrument, machine, implant or in vitro reagent, that is intended for use in the diagnosis, prevention and treatment of diseases or other medical conditions.
ISO definition: A device designed to be placed surgically within or on the mandibular or maxillary bone to provide restistance to displacement of a dental prosthesis (ISO 1942:2009). A biocompatible device placed within, or on, bone of the maxilla or mandible, to provide support for a prosthetic reconstruction.
Freeze-dried bone allograft Bone harvested from donor cadavers, washed, immersed in ethanol, frozen in nitrogen, freeze-dried and ground to similar particles ranging from 250 to 750μm. It acts primarily through an osteoconductive process, as inductive proteins, often found in only minute quantities, are only released after the resorption of the mineral.
Refers to the time of applying force on an implant after initial placement. This term mostly is used in oral surgery/dental implantology. The prosthesis is brought in function after a certain healing period. The healing period may be very different, depending on some factors like general predisposition, diseases, tissue health, intensity of use, cooperation.
Premature opening of a primary surgical tissue closure.
Measure of percentage of implant survival over a period of time.
Measure of percentage of implant success over a period of time.
Study that involves the observation of a defined population at a single point in time or time interval.
Surgical technique in which only the bony cortex is surgically cut.
Form of ceramic from the calcium carbonate skeleton of coral. It is used as a grafting material.
The direct migration of bone-building cells through the clot matrix to the implant surface.
Surgical placement of implants using a computer guided system based on information generated from a high resolution computed tomography.
Computer-aided design/computer-aided manufacturing Process for direct preparation of an object from computer-acquired or computer-generated data
Combinations of different grafting materials.
Bioabsorbable membrane made from collagen (mainly type I) with the following properties: tolerated by surrounding tissues, semi-permeable, hemostatic, chemotactic.
A longitudinal study in which a group, the cohort, is chosen for the presence of a specific characteristic at or during a specified time and followed over time to discover presumably related characteristics.
There are different definitions, non of them with exact reliable data for clinical use: 1, Histological: The “density” is calculated from the percentage of all bone tissue that is constituted by mineralized bone 2, Radiological: Mineral in bone is measured by x-ray translucency, defined as Hounsfield units. 3, Clinical: Tactile assessment of bone quality while …
Dental Popular term for the act of surgically exposing a submerged implant, following healing from stage-one surgery.
Force attempting to disengage parts joined by a screw.
Syn.: Heterogeneous graft, Heterograft. Grafting material harvested from different species from that of the recipient.
The percentage of survivals in a study or clinical trial in placing implants, defined as implants that are functioning according to predetermined criteria.
Syn.: Three dimensional imaging, three-dimensional modeling. Method of creating a three-dimensional model by using lasers driven by CAD software, from information derived from CT-scan. It is used for surgical planning and the generation of placing tools for implantation.
Autologous product derived from whole blood through the process of gradient density centrifugation. Its intended purpose lies in its ability to incorporate high concentrations of growth factors and fibrin into a graft mixture.
Growth factors released by platelets that initiate connective tissue healing including bone regeneration and repair. They also increase mitogenesis, angiogenesis and macrophage activation.
Syn.: Osteodistraction, callus distraction, callotasis. Formation of new bone between vascular bone surfaces created by an osteotomy and separated by gradual and controlled distraction. It is used in orthopedic surgery, podiatric surgery, and oral and maxillofacial surgery. Originally used to treat problems like unequal leg length, it now is used for the treatment of issues …
Surface texture of an implant that are randomly distributed, so the surface is identical in all directions.
The hard portion of the connective tissue that constitutes the majority of the skeleton. It consists of an inorganic component (67%, minerals such as calcium phosphate) and an organic component (33%, collagenous matrix and cells) Cortical bone. Syn.: Compact bone. The noncancellous hard and dense portion of bone consisting largely of concentric lamellar osteons and …
Acronym: Basic multicellular unit.
Graft consisting of an autogenous block of bone, taken from a different site and usually fixed with screws.
The ability of an (autogenous) graft to dissolve physiologically.
Able to replicate or imitate a body structure (anatomy) and/or function (physiology).
Scientific field that deals with the mechanical properties of any biomechanical device, device-tissue interface or the properties of tissues themselves.
Dental The combined apicocoronal height of connective tissue and epithelial attachment. It exists around teeth as well as around dental implants once exposed to the oral cavity.
The bonding of living tissue to the surface of a biomaterial or implant, which is independent of any mechanical interlocking mechanism.
Property of a material that elicits no host response.
syn.: Absorbable Property of a material that degrades and dissolves in vivo. Its breakdown products are incorporated into normal physiologic and biochemical processes (e.g. bioabsorbable membranes or sutures).
The engagement of an implant at the two sides of a bone, being fixed in two cortical areas.
Device helping to confine a grafted area. It can prevent movement of a graft and/or controls the growth of undesirable cells into a site with or without grafted material.
Any force applied in the direction of the long axis of an implant.
Lacking blood vessels.
Decrease in size of a cell, organ, tissue or part.
Al2O3 A metallic oxide Single crystal Polycrystal Used eg for dental implants, hip implants.
Synthetic, inorganic material. Alloplastic graft.
or allogenic graft. Graft tissue from genetically dissimilar members of the same species.
Treatment of an implant surface by addition of material, e. g. to increase the surface or build an interactive layer.
Treatment of an implant surface by acid in order to increase its surface area by subtraction.
Connective tissue is a basic human tissue. There are many subdivisions. It is found in between other tissues.
Collagen is the main component of connective tissue. A molecule characterized by a triple helical structure and a high content of glycine, proline and hydroxyproline. It is the major constituent of connective tissue fibers, the organic matrix of bone, dentin, cementum, and basal laminas. Collagen is synthesized by fibroblasts, chondroblasts, osteoblasts and odontoblasts. Several types …
colony forming unit (stem cells)
Peripheral Blood Mononuclear Cell
Human pluripotent stem cells
Mesenchyymal Stem Cell
Fibrin Assisted Soft Tissue Promotion
The nuclear receptor Rev-erbα controls circadian thermogenic plasticity. Gerhart-Hines Z, et al. Nature. 2013. Nature. 2013 Nov 21;503(7476):410-413. doi: 10.1038/nature12642. Epub 2013 Oct 27. Abstract Circadian oscillation of body temperature is a basic, evolutionarily conserved feature of mammalian biology. In addition, homeostatic pathways allow organisms to protect their core temperatures in response to cold exposure. …
The term refers to the direct structural and functional connection between living bone and the surface of a load-bearing (Albrektsson et al. in 1981) artificial implant. A more recent definition (by Schroeder et al.) defines osseointegration as “functional ankylosis (bone adherence)”, where new bone is laid down directly on the implant surface and the implant …
Tantalum is a chemical element with symbol Ta and atomic number 73. Tantalum is a rare, hard, blue-gray, lustrous transition metal that is highly corrosion-resistant. There are some specifications Tantalum is used in orthopedic and dental implants. It was used as one-material-implant and as coating. Application is rare. A current application is a dental implant with …
Tool to transfer 3D-planning of implants into the surgical procedure. There exists several types of surgical guides, mor or less precisely. For instance guides for pilote drilling give a rough direction. Hull-in-hull-systems allow more precisely drilling with hulls, fitting to different drill diameters. Depth control is possible.
There are some risk groups in planning implant surgery, e.g.: Blood disorder, coagulation Tumors Diabetes mellitus HIV Corticosteroids Biphosphonate Medication Bone disorders Dysfunction, Dysgnathia Smokers Handicapped These groups need special planning, special care and contraindication may be wise.
Thrombocytes stop bleeding. They aggregate at the contact with collagen and the proteins from the implant surface and close the ruptured vessels. Thrombocytes release messengers, to support crosslinking (thromboxan), to fibroblast building with PDGF(platelet derived growth factor). Fibrin monomers crosslink. Adsorption of an implant materials iones and blood proteines (albumines, fibrinogen, fibronektin).
Kaplan-Meier estimate is one of the best options to be used to measure the fraction of subjects living for a certain amount of time after treatment. In clinical trials or community trials, the effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of …
At the cathode electrons enter the cell and reduction occurs (“+”).
An anode is an electrode, where electrons leave the cell and oxidation occurs (“-“).
An electrode is an electrical conductor used to make contact with a nonmetallic part of a circuit (e.g. a human tissue). It can be either an anode (“-“) or a cathode (“+”).
Minimally Invasive Surgery
free from infection
Removing an implant.
Osteopromotion involves the enhancement of osteoinduction without the possession of osteoinductive properties. For example, enamel matrix derivative has been shown to enhance the osteoinductive effect of demineralized freeze dried bone allograft (DFDBA), but will not stimulate new bone growth alone.
Osteoinduction involves the stimulation of osteoprogenitor cells to differentiate into osteoblasts that then begin new bone formation. The most widely studied type of osteoinductive cell mediators are bone morphogenetic proteins (BMPs).
Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone. Osteoblasts from the margin of the defect that is being grafted utilize the bone graft material as a framework upon which to spread and generate new bone. In the very least, a bone …
Combinations of materials of biological or non-biological origins or both.
Products made from primary materials of inorganic origin (mineral or synthetic).
Products derived from living tissues (animal or vegetable).
Designed to assist or modify a biological activity.
Progressive alteration of a material in a biological environment.
Progressive alteration or breakdown of a material in a biological environment.
Maintaining, restoring or augmenting the volume of tissue with biomaterial, resorbable or non-resorbable.
A biomaterial, resorbable or non-resorbable, surgically placed to restore lost bony substance.
A biomaterial, resorbable or non-resorbable, placed surgically on the surface of a bone, with or without loss of tissue, to obtain selective or guided tissue regeneration.
A material intended to interface with the biological System to evaluate, treat, augment or replace tissue, organ or function of the organism. Material specially prepared and/or presented to exhibit bioacceptability, biocompatibility or positive biocompatibility.
The quality of a biomaterial that satisfies those functional specifications for which it was designed.
Capacity of a material to fulfil its function with an appropriate response for a specific application from the receiving host. Quality of being accepted in a specific living environment without adverse or unwanted side effects. ——————————————————————————————————————— Biomaterials are non-living natural or synthetic materials that are used in contact with the living body and must therefore be biocompatible …
porcine endogenous retroviruses
De novo production of bone out of pluripotent reserve cells (stem cells), they are present in perivascular tissue and bone and they may activated through morphogene factors. Osteoinductive substances must lead to an ektope bone building at an extraskeletal place.
surface-decalcified allogeneic bone
A nonbiologic material such as metal, ceramic, and plastic.
xenogenous Tissue grafts, when donor and recipient belong to different species. A heterologous transplant means ‘between species’ or ‘from one species to another’.
heterologous Tissue grafts, when donor and recipient belong to different species.
allogeneic Being genetically different although belonging to or obtained from the same species.
allogenic Being genetically different although belonging to or obtained from the same species.
A transplant between twins.
In transplantation (and blood transfusion), when the donor and recipient are the same person.
also “Zirconia” ZrO2 physical Density 5,68 g/cm³ Medical used Zirconium dioxides usually come with some dopants, which clearly improve physical properties chemical The change of volume caused by the structure transitions from tetragonal to monoclinic to cubic induces large stresses, causing it to crack upon cooling from high temperatures. When the zirconia is blended with …
A cyborg, abb. for “cybernetic organism” has both organic and biomechatronic body parts. The term cyborg is different from bionic, biorobot or android.
Bionics or biologically inspired engineering is the application of biological methods and systems found in nature to the study and design of engineering systems and modern technology.