Surgical implant and tissue interface

Stability of implant-tissue interface is vital for implant integration with adjacent tissue and it influences directly short- and long-term surgical outcome. The literature provides comprehensive research on implants engaged in soft as well as in hard tissues. Various factors have been found to significantly influence the interface stability. This comprehensive work incorporated several research projects with main focus on implant-tissue interface stability, which was evaluated using biomechanical assessment tools such as pullout, four-point bending as well as reverse torque test. Implants were evaluated under ex vivo conditions, immediately after being placed within tissue as well as under in vivo conditions, 2- and 6-months following the implantation surgery in goat and equine animal model. Several viewpoints of implant - tissue interface have been addressed in the following studies. Stability of the interface has been found to be primarily influenced by amount of load experienced by the implants, stress applied to adjacent tissue as well as bioactive coatings. The following studies offer novel technologies which improved implant - tissue interface stability and significantly enhanced tissue regeneration. These technologies include novel design laryngeal clamps and novel technology polyurethane scaffolds coated with bioactive nanophase Hydroxyapatite. Projects included in this dissertation concern stresses applied by the suture to adjacent laryngeal cartilage or collateral ligaments, enthesis restoration using commercially available suture anchors, as well as stability of suture anchor and stainless-steel screw within bone tissue under different loading conditions. The final chapters concern integration of tissue scaffold coated bioactive agents.Research incorporated in this work found that increased tissue and implant contact area resulted in increased interface stability and better osseointegration. Further, osseointegration process varied between each screw used to fix dynamic compression plate to bone varied. Bioactive coatings such as nanophase Hydroxyapatite were found to significantly enhance osseointegration of bone scaffolds and resulted in significantly enhanced bone regeneration.