背景:植入物的有效放置关键取决于植入物与牙槽骨的骨结合水平。为了在植入过程中增加骨整合,研究集中在植入物的表面改性上,和形态学分析研究了与骨骼表面紧密相互作用的螺纹图案。
目的:本研究旨在评估和比较不同表面修饰技术下口腔种植体骨整合的程度。
方法:在本研究中,使用12只年龄为18-24个月的健康成年犬。在下颌骨的两侧进行拔牙,伤口用缝线缝合。两个月后,每只狗的右下颌骨接受局部麻醉和全身麻醉。根据其表面处理放置了四种不同的植入物类型:可吸收爆炸介质(RBM)处理的植入物,具有超薄HA膜的羟基磷灰石(HA)植入物,用HA涂覆的水热处理的HA植入物,用等离子喷涂和酸蚀刻处理的喷砂联合酸蚀刻(SLA)植入物。总共48个植入物被分为两周和四周组,具有相同的尺寸。每只狗接受两组植入物,每只狗总共植入八个植入物。将植入物以大于35-N的扭矩牢固地放置在上牙槽骨中,直到深度为1mm。PeriotestM(MedizintechnikGuldene.K.,Modautal,Germany)用于在放置和处死后立即计算每个植入物的颊侧的典型值,以测试植入物的主要固定和稳定性。OsstellMentor(OsstellAB,哥德堡,瑞典)同时评估内侧的植入物稳定性商(ISQ),远端,颊,和植入物的舌侧。使用MGT50(ELECTROMATICEquipmentCo.,Inc.,纽约,美国)扭矩分析仪。使用光学显微镜(OlympusCorporation,东京,日本)。上半部的骨-种植体接触(BIC),这对植入物的稳定性更重要,研究了新骨形成面积(NBFA)与完整植入物的比率。
结果:在第四周,在HA处理的植入物中观察到最大的稳定性。在第四周在水热处理的HA植入物中观察到最小的稳定性。与两周评估相比,在四周评估中每组的稳定性更大。在两周和三周的评价中,几乎所有植入物的稳定性都是令人满意的。在HA处理的植入物中观察到在两周和四周评估时新形成的骨的百分比面积的最大值。分别在SLA和RBM处理的植入物中观察到在两周和四周评估时新形成的骨的面积百分比的最小值。差异有统计学意义(p≤0.05)。
结论:所有植入物表面改性,总的来说,产生令人满意的骨整合。在具有水热处理的HA的植入物的上部观察到优异的骨整合。
BACKGROUND: Effective implant placement depends critically on the implant\'s level of osseointegration with the alveolar bone. To increase osseointegration during implant placement, research has concentrated on the surface modification of implants, and morphological analyses have looked at the thread pattern in close interaction with the bone\'s surface.
OBJECTIVE: This study aimed to assess and compare the extent of oral implant osseointegration in different surface modification techniques.
METHODS: In this study, 12 healthy adult dogs aged 18-24 months were used. Tooth extractions were performed on both sides of the mandible, and wounds were closed with sutures. Two months later, the right mandible of each dog underwent local anesthesia and general anesthesia. Four different implant types were placed based on their surface treatments: resorbable blast media (RBM)-treated implants, hydroxyapatite (HA) implants with an ultra-thin HA film, hydrothermal-treated HA implants coated with HA, and sandblasting combined acid etching (SLA) implants treated with plasma spray and acid etching. A total of 48 implants were divided into two- and four-week groups, with identical dimensions. Each dog received two implants from each group, for a total of eight implants per dog. The implants were securely placed into the superior alveolar bone with a torque greater than 35-N up to a depth of 1 mm. Periotest M (Medizintechnik Gulden e.K., Modautal, Germany) was used to calculate the periotest value (PTV) as a typical value on the buccal side of each implant immediately following placement and sacrifice to test the main fixation and stability of the implants. Resonance frequency analysis (RFA) was utilised by Osstell Mentor (Osstell AB, Gothenburg, Sweden) to simultaneously assess the implant stability quotient (ISQ) on the medial, distal, buccal, and lingual sides of the implant. The rotational torque in one of the sacrificed dogs was calculated using the MGT 50 (ELECTROMATIC Equipment Co., Inc., New York, USA) torque analyzer. The histomorphometric evaluation was performed using an optical microscope (Olympus Corporation, Tokyo, Japan). The upper half\'s bone-implant contact (BIC), which was found to be more important for implant stability, was studied together with the ratio of the new bone formation area (NBFA) to the complete implant.
RESULTS: The maximum stability was observed in HA-treated implants in the fourth week. The minimum stability was observed in hydrothermal-treated HA implants in the fourth week. The stability in each group was greater in the four-week evaluation as compared to the two-week evaluation. The stability was satisfactory in almost all implants at two- and three-week evaluations. The maximum value of the percentage area of newly formed bone at the two- and four-week evaluations was observed in HA-treated implants. The minimum value of the percentage of the area of newly formed bone at two- and four-week evaluations was observed in SLA and RBM-treated implants respectively. The difference was significant statistically (p ≤ 0.05).
CONCLUSIONS: All implant surface modifications, in general, produced satisfactory osseointegration. Excellent osseointegration was seen in the upper portion of the implant with hydrothermally treated HA.