Contributor contact details |
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xiii | |
Woodhead Publishing Series in Biomaterials |
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xvii | |
Foreword |
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xxi | |
Introduction |
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xxiii | |
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Part I Introduction to biocompatibility in medical devices |
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1 | (62) |
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1 Concepts in biocompatibility: new biomaterials, new paradigms and new testing regimes |
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3 | (15) |
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1.1 Introduction: traditional biomaterials and biocompatibility test procedures |
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3 | (3) |
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1.2 The evolution from implantable medical devices to regenerative medicine and bionanotechnology |
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6 | (2) |
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1.3 New concepts and definitions for biocompatibility |
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8 | (5) |
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1.4 A proposed conceptual framework for new biocompatibility concepts and testing regimes |
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13 | (3) |
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1.5 Conclusions and future trends |
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16 | (1) |
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17 | (1) |
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2 Challenges in biocompatibility and failure of biomaterials |
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18 | (12) |
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18 | (1) |
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2.2 Concept of biocompatibility |
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19 | (3) |
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2.3 Examples of device recalls or alerts during the last decade in which biocompatibility issues were considered |
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22 | (3) |
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2.4 Challenges in biocompatibility evaluation |
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25 | (3) |
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28 | (1) |
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29 | (1) |
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3 Biological safety evaluation planning of biomaterials |
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30 | (7) |
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30 | (1) |
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3.2 The fundamentals of safety evaluation planning |
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30 | (2) |
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3.3 Safety evaluation planning for biomaterials |
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32 | (1) |
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3.4 Developing and documenting plans |
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33 | (1) |
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3.5 Using safety evaluations |
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34 | (1) |
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35 | (1) |
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3.7 Sources of further information and advice |
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36 | (1) |
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4 Biomechanical and biochemical compatibility in innovative biomaterials |
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37 | (26) |
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37 | (1) |
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4.2 Selection of biomaterials |
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38 | (2) |
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4.3 Three generations of biomedical materials |
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40 | (1) |
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4.4 State-of-the-art development |
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41 | (9) |
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50 | (4) |
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54 | (2) |
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56 | (7) |
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Part II Evaluation and characterisation of biocompatibility in medical devices |
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63 | (206) |
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5 Material and chemical characterization for the biological evaluation of medical device biocompatibility |
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65 | (30) |
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65 | (1) |
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66 | (3) |
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5.3 Requirements of ISO 10993 |
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69 | (2) |
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5.4 Characterization of materials |
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71 | (3) |
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5.5 Chemical characterization of extracts |
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74 | (7) |
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5.6 Using chemical and material characterization to demonstrate equivalency |
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81 | (3) |
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5.7 Acceptance criteria for equivalency |
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84 | (2) |
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5.8 Risk assessment of extracts |
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86 | (6) |
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5.9 Conclusion and future trends |
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92 | (1) |
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93 | (2) |
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6 Allowable limits for toxic leachables: practical use of ISO 10993-17 standard |
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95 | (25) |
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95 | (3) |
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6.2 Process for setting tolerable intake (TI) values for compounds released from medical device materials |
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98 | (5) |
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6.3 Derivation of non-cancer TI values |
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103 | (5) |
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6.4 Derivation of cancer-based TI values |
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108 | (3) |
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6.5 Derivation of TI values for local effects |
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111 | (1) |
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6.6 Other issues to consider |
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112 | (2) |
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114 | (1) |
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115 | (5) |
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7 In vivo and in vitro testing for the biological safety evaluation of biomaterials and medical devices |
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120 | (39) |
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120 | (1) |
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7.2 Pre-testing considerations |
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121 | (5) |
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126 | (1) |
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127 | (9) |
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136 | (21) |
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157 | (1) |
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157 | (2) |
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8 Practical approach to blood compatibility assessments: general considerations and standards |
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159 | (42) |
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159 | (1) |
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8.2 Background: blood composition |
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160 | (7) |
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8.3 Critical distinguishing factors presented by blood-contacting medical devices |
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167 | (6) |
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8.4 Responses in fluid blood in contact with medical devices |
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173 | (4) |
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8.5 Responses by materials, or upon their surfaces, in contact with blood |
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177 | (8) |
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8.6 Assessing hemocompatibility according to international standards |
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185 | (8) |
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8.7 Conclusion and future trends |
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193 | (1) |
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8.8 Sources of further information and advice |
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194 | (2) |
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196 | (5) |
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9 Medical device biocompatibility evaluation: an industry perspective |
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201 | (26) |
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201 | (1) |
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9.2 Developing a biological evaluation plan |
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202 | (2) |
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9.3 Implementing a biological evaluation plan |
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204 | (3) |
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9.4 Biological safety testing |
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207 | (3) |
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9.5 Creating a biological evaluation report |
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210 | (2) |
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9.6 Conclusion and future trends |
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212 | (3) |
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9.7 Sources of further information and advice |
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215 | (6) |
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221 | (3) |
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9.9 Appendix: example of a material component biological evaluation report template |
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224 | (3) |
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10 Case study: overcoming negative tests results during manufacture |
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227 | (6) |
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227 | (1) |
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10.2 Cardio Medical: a fictitious case study |
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228 | (1) |
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10.3 The biological safety program |
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229 | (1) |
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10.4 Extractables and leachables |
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229 | (1) |
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10.5 Controlling risk at the manufacturing level |
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230 | (1) |
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10.6 Sterilization residuals |
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231 | (1) |
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232 | (1) |
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11 Methods for the characterisation and evaluation of drug-device combination products |
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233 | (36) |
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11.1 Introduction to combination products |
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233 | (1) |
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11.2 Combination product regulation |
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234 | (1) |
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11.3 Demonstrating safety and efficacy of combination products |
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235 | (2) |
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11.4 Pre-clinical testing of combination products |
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237 | (21) |
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11.5 Aspects to consider in the manufacture of combination products |
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258 | (3) |
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11.6 Clinical studies for combination products |
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261 | (2) |
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11.7 Conclusion and future trends |
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263 | (1) |
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264 | (5) |
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Part III Testing and interpreting the performance of medical devices |
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269 | (112) |
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12 Methods and interpretation of performance studies for bone implants |
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271 | (37) |
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271 | (1) |
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272 | (2) |
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274 | (1) |
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12.4 Principles for the selection of an in vivo model to evaluate performance of bone implants |
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275 | (4) |
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12.5 Designing a study to evaluate performance of bone implants |
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279 | (3) |
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12.6 Selection of reference products and controls |
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282 | (3) |
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12.7 Osteoinductive and osteogenic performances |
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285 | (1) |
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12.8 In vitro limitations |
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286 | (2) |
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12.9 Fracture repair models |
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288 | (4) |
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12.10 Spinal fusion models |
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292 | (2) |
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12.11 Cylindrical defect models |
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294 | (1) |
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12.12 Segmental defect models |
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295 | (1) |
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12.13 Antimicrobial performances of implants |
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296 | (1) |
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12.14 Bioabsorbable and biodegradable materials |
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297 | (1) |
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12.15 Bone debris interaction with implant performance |
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298 | (1) |
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299 | (2) |
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301 | (7) |
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13 Methods and interpretation of performance studies for dental implants |
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308 | (37) |
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13.1 Introduction and definitions |
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308 | (1) |
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13.2 Importance of performance evaluation studies for dental implants |
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309 | (2) |
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13.3 Experimental design of a performance trial for dental implants |
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311 | (9) |
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320 | (3) |
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13.5 Statistical power calculation and analysis |
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323 | (3) |
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326 | (11) |
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13.7 Translation from animal studies to human clinical trials |
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337 | (1) |
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337 | (1) |
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13.9 Sources of further information and advice |
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338 | (1) |
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338 | (7) |
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14 Non-clinical functional evaluation of medical devices: general recommendations and examples for soft tissue implants |
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345 | (17) |
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14.1 Introduction and definitions |
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345 | (1) |
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14.2 The purpose of functional studies |
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346 | (2) |
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14.3 Standards and documentation |
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348 | (1) |
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14.4 How to design a functional study |
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349 | (8) |
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14.5 Combining non-clinical functional studies with requirements of safety standards |
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357 | (1) |
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358 | (1) |
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359 | (3) |
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15 Mechanical testing for soft and hard tissue implants |
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362 | (19) |
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362 | (1) |
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15.2 Principles of setting up a mechanical test |
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363 | (5) |
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15.3 Implant-specific mechanical performance testing |
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368 | (7) |
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15.4 Advanced therapy products (ATPs) - cartilage |
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375 | (2) |
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15.5 Conclusion and future trends |
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377 | (1) |
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15.6 Sources of further information and advice |
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377 | (1) |
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378 | (3) |
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Part IV International regulation of medical devices |
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381 | (74) |
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16 Biological evaluation and regulation of medical devices in the European Union |
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383 | (21) |
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383 | (1) |
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16.2 The regulatory and legislative framework |
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383 | (2) |
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16.3 Essential requirements |
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385 | (3) |
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16.4 Presumption of conformity |
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388 | (1) |
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16.5 Using the EN ISO 10993 series of standards to meet the essential requirements |
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389 | (2) |
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391 | (4) |
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16.7 Common pitfalls in biological evaluations |
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395 | (4) |
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16.8 Managing positive results in the biological safety assessment |
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399 | (1) |
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16.9 Presenting the biological evaluation within the technical file |
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400 | (1) |
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401 | (1) |
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16.11 Sources of further information and advice |
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401 | (1) |
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16.12 Appendix: model content of the biological evaluation submission |
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401 | (3) |
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17 Biological evaluation and regulation of medical devices in Japan |
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404 | (45) |
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404 | (1) |
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17.2 Outline of biological safety testing in Japan |
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405 | (3) |
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17.3 Biological safety tests |
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408 | (32) |
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17.4 Relationship and comparison between the International Organization for Standardization (ISO) standard and American Society for Testing and Materials (ASTM) standard |
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440 | (2) |
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17.5 Relationship between classification, examination, and certification in Japan |
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442 | (2) |
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17.6 Outline of the medical device Good Laboratory Practice (GLP) |
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444 | (1) |
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444 | (2) |
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446 | (3) |
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18 Medical device regulations in China |
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449 | (6) |
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449 | (1) |
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18.2 Interpretation of ISO 10993 and additional State Food and Drug Administration (SFDA) requirements |
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449 | (3) |
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18.3 Major professional bodies |
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452 | (2) |
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454 | (1) |
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Part V Histopathology principles for biocompatibility and performance studies |
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455 | (46) |
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19 Microscopic and ultrastructural pathology in medical devices |
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457 | (44) |
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457 | (2) |
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19.2 Morphologic assessment in the safety studies of biomaterials and medical devices |
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459 | (9) |
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19.3 Assessment of the performance of biomaterials and medical devices |
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468 | (7) |
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19.4 Processing and sectioning of specimens |
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475 | (3) |
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19.5 Staining recommendations |
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478 | (1) |
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19.6 Qualitative and quantitative pathology used in the evaluation of biomaterials and medical devices |
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479 | (4) |
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19.7 Ultrastructural pathology |
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483 | (5) |
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19.8 Morphologic assessment of ocular medical devices |
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488 | (6) |
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494 | (1) |
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495 | (1) |
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496 | (5) |
Index |
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501 | |