BACKGROUND: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. METHOD: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. RESULTS: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. CONCLUSIONS: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to 1200 mum had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.
Atrophy* ; Biocompatible Materials ; Durapatite* ; Humans ; In Vitro Techniques ; Methods ; National Library of Medicine (U.S.) ; Porosity ; Transplants

Background/Aims: Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods: This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates. Results: In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215). Conclusions PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.

Background/Aims: Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods: This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates. Results: In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215). Conclusions PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.

Background/Aims: Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP). Methods: This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates. Results: In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215). Conclusions PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.