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Abstract
OBJECTIVE To compare the biomechanical behavior of mandibular critical-sized defects stabilized with 2 plating configurations under in vitro conditions resembling clinical situations.
SAMPLE 24 mandibles harvested from 12 adult canine cadavers.
PROCEDURES 8 mandibles were kept intact as control samples. A critical-sized defect was created in 16 mandibles; these mandibles were stabilized by use of a single locking plate (LP [n = 8]) or an LP combined with an alveolar miniplate (LMP [8]). Mandibles were loaded in cantilever bending in a single-load-to-failure test with simultaneous recording of load and actuator displacement. Stiffness, yield, and failure properties were compared among groups. Mode of failure was recorded. Radiographic evidence of tooth root and mandibular canal damage was quantified and compared between groups.
RESULTS Stiffness and yield loads of single LP and LMP constructs were < 30% of values for intact mandibles, and failure loads were < 45% of values for intact mandibles. There were no consistent biomechanical differences at failure between single LP and LMP constructs, but the LMP construct had greater stiffness and strength prior to yield. Frequency of screw penetration of teeth and the mandibular canal was significantly greater for LMP than for single LP constructs.
CONCLUSIONS AND CLINICAL RELEVANCE Both fixation methods were mechanically inferior to an intact mandible. The LMP construct was mechanically stronger than the LP construct but may not be clinically justifiable. Addition of an alveolar miniplate provided additional strength to the construct but resulted in more frequent penetration of tooth roots and the mandibular canal.
Abstract
OBJECTIVE To evaluate biomechanical properties of intact feline mandibles, compared with those for mandibles with an experimentally created osteotomy that was stabilized with 1 of 2 internal fixation configurations.
SAMPLE 20 mandibles from 10 adult feline cadavers.
PROCEDURES An incomplete block study design was used to assign the mandibles of each cadaver to 2 of 3 groups (locking plate with locking screws [locking construct], locking plate with nonlocking screws [nonlocking construct], or intact). Within each cadaver, mandibles were randomly assigned to the assigned treatments. For mandibles assigned to the locking and nonlocking constructs, a simple transverse osteotomy was created caudal to the mandibular first molar tooth after plate application. All mandibles were loaded in cantilever bending in a single-load-to-failure test while simultaneously recording load and actuator displacement. Mode of failure (bone or plate failure) was recorded, and radiographic evidence of tooth root and mandibular canal damage was evaluated. Mechanical properties were compared among the 3 groups.
RESULTS Stiffness, bending moments, and most post-yield energies for mandibles with the locking and nonlocking constructs were significantly lower than those for intact mandibles. Peak bending moment and stiffness for mandibles with the locking construct were significantly greater than those for mandibles with the nonlocking construct. Mode of failure and frequency of screw damage to tooth roots and the mandibular canal did not differ between the locking and nonlocking constructs.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that both fixation constructs were mechanically inferior to intact mandibles. The locking construct was mechanically stronger than the nonlocking construct.
Abstract
OBJECTIVE
To establish the pharmacokinetics of the cyclin-dependent kinase-9 inhibitor flavopiridol in equine middle carpal joints, using an extended-release poly lactic-co-glycolic acid (PLGA) microparticle formulation.
ANIMALS
4 healthy horses without evidence of forelimb lameness.
METHODS
A 6-week longitudinal pharmacokinetic study was conducted in 2 phases (6 weeks each) in 4 healthy horses. The PLGA microparticles containing 122 μg flavopiridol in 3 mL saline were administered by intra-articular injection into 1 middle carpal joint, with empty PLGA microparticles injected into the contralateral joint as a control. Synovial fluid and plasma were collected at time points out to 6 weeks, and drug concentrations in synovial fluid and plasma were determined using validated protocols. Synovial fluid total protein and total nucleated cell count and differential, CBC, serum biochemistry, and lameness exams were performed at each of the time points.
RESULTS
Synovial fluid flavopiridol averaged 19 nM at week 1, gradually reduced to 1.4 nM by 4 weeks, and was generally below the detection limit at 5 and 6 weeks. There was no detectable flavopiridol in the plasma samples, and no adverse effects were observed at any time point.
CLINICAL RELEVANCE
Intra-articular injection of PLGA microparticle-encapsulated flavopiridol was well tolerated in horses, with detectable levels of flavopiridol in the synovial fluid out to 4 weeks with negligible systemic exposure. Flavopiridol is a cyclin-dependent kinase-9 inhibitor with potent anti-inflammatory and analgesic activity. The extended-release microparticle formulation promotes intra-articular retention of the drug and it may be an alternative to other intra-articular medications for treatment of equine joint disease.