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Tissue Engineering 2 Interazione cellula/ Biomateriale - Coggle Diagram

- - - - Comments:
    - - :left_speech_bubble:Blands of materials with differents properties. like carbon fibers. very tiny carbon fibers that are very fragile, inmersed in a polymer matrix so the carbon fiber takes most of the load (rigid) the matrix is flexible. together hybrid propeerties of flexibility and stiffness. Reinformce the material wth particles, creation something unique with unique properties
  - - - Permanent
      - Non permanent- temporary
    - - BioInert
      - Bioactive
        
        Stimulates some pathway or ressponse
      - :warning:Toxic
- - - - :left_speech_bubble:Comments: Material is implanted and the material looses its properties over time. Phenomenon is not simple.
        Bioresorbable: Degradation is uniform in all the volume of the implant. Degradation of the ful volume of the material . Like sugar
        Bioerodible like candy solubileze thee surface, dissolve from the outside towards the inside. surface degradation
        Bioabsorbable no cleavege of the material.
        All equals loose of properties
      - :left_speech_bubble:We can also have enzymatic or hydrolysis of the polymer ( degaration into subunits or pieces of it. Is break down and absdrob in vivo.
- - - - Tissue attachment
    - - Contraction
      - Reaction to particles; tissue destruction
        :left_speech_bubble: realse of particles due to shear on the tissue or the other materials od the tehm. abbrazion of the surfce realses particles, the particles in the volume 100um should be romeved by maccrophages, but this is inflammation. Problem, how to control inflammation.
- - - - :left_speech_bubble: different materials, metals, stainless stel, titatium, cobalt allows, peg, or ceramic. Bone has to bound to the implnat, only once it is bound we can talk about mechanical properties .
  - - - American Academy of Implants Dentistry
    - - Fori passanti
        
        Rugosità superficiale
        
        Superficie macroporosa
        
        Coating di idrossiapatite o Cap
        
        :left_speech_bubble: Startegies, holes, increase the superficial ruffness, macropores structures , coationg with hidroxiapaptoe or calcium phosphates, bioactive material)
    - - PER LA REALIZZAZIONE DI PROTESI NON CEMENTATE, AMPIA DIFFUSIONE HANNO TROVATO L’IMPIEGO DI RIVESTIMENTI OSTEOCONDUTTORI DI IDROSSIAPATITE (HA) E FOSFATI DI CALCIO DEL TIPO Ca10(PO4)6OH2 AVENTI LA STESSA COMPOSIZIONE DELL’OSSO MINERALE.
      - Air plasma spray (APS)
        
        Vaccum Plasma Spray (VPS)
        
        Spessori medi di rivestimento (50-150 um)
      - Esempi :
        
        Stelo femorale con coating osteoconduttivo + ental implants
        
        Bone regeneration in the gap between the implant surface. gap between coasting, implant, and tissue, and the surrounding bone . comparation between 3h, 6 days, ( tissue- cating. almosto no gap tissue and implant. At 14 days new bone that grows into the implant, integrated into the layer of hydroxiapatite layer
- - - - FDA has developed this website to display photographs and(or illustrations of brest implant complications
        
        :left_speech_bubble: differnet ways to make the implat. muscle position. Contraction due to sca tissue, deforms the implant
    - - Capsular contracture may be more common following infection, hematoma and seroma. However, the cause of capsular contracture is not known.
    - - Grade I: Breast is normally soft and looks natural
      - Grade II: Breast is a little firm but looks normal( no evident deformation)
      - Grade III: Breast is firm and looks abnormal
      - Grade IV: Breast is hard, painful, and looks abnormal
      - Grades III and IV capsular contracture are considered severe and may require reoperation. The surgical procedure usually involves removal of the implant with or without replacement of the implant. There is a possibility that capsular contracture could occur again after surgery to correct it.
    - - Myofibroblasts, and the regulatory protein TGFβ, were found in the contracted capsules around silicone breast implants but not in non-contracted capsules.
        
        Mature skin scar tissue did not contain TGFβ or myofibroblasts.
        
        Lossing C. Hansson HA
        
        Plast Reconstr Surg 91, 1277 (1993)
        
        :left_speech_bubble: what make sthe difference of presence of mycobfiblast?
    - - Textured implants help determine contracture because of their rough surface which is intended to discourage a hard capsule from forming.
        
        Under the muscle placement of the implant reduces risk of capsular contracture by an average of 8-10%. Whereas over the muscle has 10-25% or more chance of capsule contracture.
        
        Textured breast implants are associated with BIA-ALCL, a cancer of the immune system. The FDA has quantified the risk from 1 in 3,000 patients to up to 1 in 30,000 patients. The risk of this lymphoma likely depends on the specific manufacturer of a textured implant and, in some cases, may be lower than these estimates.
- - - - :left_speech_bubble: Friction of he head of the prosstesys , released of the small particles, over time, a ontinous mehanisc. it cannot be stopped. ( true for silicone implants taht could leak, they systemic imflammation. when discoverdedd, already too late., silicone has permeadeted the whole tisssue. in hip replacement, macrophages wantto solubilize the particles, if it os too much, the patient cann have fever, etc, systemic inflammation. most of the problem is inside the bone, problem interface bone-prosthesis, weaker bone, the bone around od the prsothesis can breask, due to the inflammation that began with the realase of particles.
- - - - Osteolysis progressiva ( Particle disease seen as plague on total joint replacement)
    - - Process takes over years, radiological evidence up to s2 years after implantation, shear reduction, 4 years, there is close to no nbone around the prosthesys, can break either the bone or the prstheiss
  - - - Per linfoadenopatia si intende l’ingrossamento dei linfonodi di qualsiasi natura. Le particelle estranee vengono drenate dal sistema linfatico nei linfonodi.
      - :left_speech_bubble: some particles get transported by inmmune cells to the lyph nodes and the rest of the body
  - - - H. McKellop, Hip Society 1994
      - :left_speech_bubble: can be reduced thanks to coating
    - - Respired volume in man: 1 litre/min
      - 10% of the inhaled particles are deposited in the lungs,
      - therefore 10e4 particles are deposited in the lungs per minute: 5x10e9 particles/year