纯钛种植体激光-微弧氧化表面处理对早期骨结合的影响

目的:对比机械光滑表面和经激光-微弧氧化处理表面的纯钛种植体的理化性能,及其对早期骨结合的影响。方法:将纯钛棒加工制作成16颗螺纹柱形种植体,对照组(光滑组)为机械加工光滑表面种植体8颗,实验组(激光-微弧氧化组)为经激光-微弧氧化处理种植体8颗。通过能谱分析仪(EDX)和扫描电镜(SEM)分析种植体表面性质,Veeco粗糙仪检测其粗糙度(Ra)。分别将16颗种植体随机植入新西兰兔的胫骨,4周后处死取样,处死前第13天和第14天皮下注射四环素,处死前第3和第4天皮下注射钙黄绿素,通过四环素-钙黄绿素双色标记示踪检测其矿化速率。将标本通过塑料包埋制作成不脱钙含种植体骨切片,观察种植体-骨界面的骨结合情况。结果:实验组表面可见较大级别微孔,基本与激光处理后一致,孔径约100μm,孔深40⁸0μm。种植体表面微弧氧化膜具有多微孔结构,微孔孔径约180μm。种植体表面微弧氧化膜具有多微孔结构,微孔孔径约1⁵μm,微孔内还可见更小级别微孔,孔径小于1μm。对照组种植体表面Ra值为0.179μm,实验组表面的微弧氧化膜Ra值为1.55μm。对照组只检测到Ti元素,实验组钛表面氧化膜层中含Ti、O、Ca、P元素。实验组的矿化速率和种植体与骨接触的百分率(OI值)均显著高于对照组(P<0.05)。结论:通过激光-微弧氧化表面处理,纯钛种植体表面形成多层次多微孔的微弧氧化膜,具有良好的生物相容性和骨引导性,能促进种植体骨结合。     

纯钛表面GRGDSP多肽对骨结合能力的影响

目的： 将钛合金种植体微弧氧化(MAO)后,以多巴胺（PDA）为偶联,加载GRGDSP多肽,形成复合活性涂层,评价其骨结合能力。方法： 选取18只成年新西兰大白兔,建立单侧下颌骨模型,并将A组（Ti-MAO）、B组（Ti-MAO-PDA）、C组（Ti-MAO-PDA-GRGDSP）分别植入到新西兰大白兔一侧下颌骨,选取2周、4周、8周下颌骨植入样本,应用锥形束CT（CBCT）观察种植体周围骨结合情况。对4周样本以扫描电镜（SEM）观察界面形貌,激光共聚焦显微镜观察样本成骨活跃程度,扭力实验观察骨结合力。采用SPSS19.0软件包对数据进行单因素方差分析。结果： CBCT观察,C组接触区骨结合情况好于B组和A组,且B组优于A组。扫描电镜观察, C组在种植体与骨接触区聚集了更多新骨。激光共聚焦显微镜观察交界处,C组与B组较A组荧光强度明显,其中C组最为明显。扭力观察,8周时B、C组扭力值为A组的2倍,C组较B组多8 N·cm;C组、B组与A组相比,差异有统计学意义（P<0.05）。结论： Ti-MAO-PDA与Ti-MAO-PDA-GRGDSP涂层对骨结合均有促进作用,其中Ti-MAO-PDA-GRGDSP涂层对骨结合的作用最明显。     

纯钛烤瓷中微弧氧化处理的实验研究

目的:探讨微弧氧化处理应用对钛与瓷的结合强度的影响,摸索微弧氧化处理的适宜条件.方法:对钛表面进行喷砂、抛光、喷砂加微弧氧化处理和抛光加微弧氧化处理后,分为4组表面进行纯瓷粉烧结.根据ISO 9693标准,对钛瓷间的三点弯曲结合强度进行测试.镍铬合金与瓷的结合强度测试结果为对照.结果:粗糙面微弧氧化组钛瓷结合强度(45.84±3.15MPa)与NiCr/VITA 99组的结合强度(48.35±3.06MPa)相比,在统计学上无显著差异(P0.05),却明显大于粗糙而组的结合强度(36.12±3.03MPa)(P<0.05);光滑面组钛/瓷结合强度(30.79±1.43MPa)明显小于粗糙面组光滑面组(P<0.01),但大于光滑面微弧氧化组(24.12±3.38MPa)(P<0.05).结论:纯钛表面喷砂后进行微弧氧化处理,可有效地提高钛瓷的结合强度.     

微弧氧化表面改性纯钛的致敏实验研究

目的探讨微弧氧化表面改性纯钛的致敏性。方法用白化豚鼠作为实验动物,用最大剂量法对材料的致敏性进行评价。实验组动物11只,用微弧氧化处理后的纯钛片制备浸提液;阴性对照组动物10只,用硅橡胶片制备浸提液;阳性对照组动物10只,用浸饱二硝基氯苯丙酮溶液的滤纸片制备浸提液。经过皮内诱导、局部诱导和激发后,观察各组豚鼠的皮肤反应并评分。结果阴性对照组动物激发部位的皮肤均无红斑和水肿,记分均为0分。实验组动物激发部位的皮肤反应与阴性对照组类似,均无红斑和水肿,记分均为0分。阳性对照组动物激发部位的皮肤均出现了明显红斑和水肿,部分动物还有焦痂形成,记分均为3分。结论经微弧氧化表面改性的纯钛无明显致敏性。     

纯钛表面微弧氧化膜的耐腐蚀性研究

目的：探讨微弧氧化处理前后纯钛耐腐蚀能力的变化。方法：用微弧氧化电源在4枚纯钛试件表面制备微弧氧化膜，4枚未经微弧氧化处理的纯钛试件作为对照组，利用扫描电子显微镜观察两组钛试件形貌特点，用X射线衍射仪测量微弧氧化膜的晶相结构，利用电化学方法在模拟体液中测定两组钛试件的极化曲线和交流阻抗。结果：微弧氧化处理后，纯钛表面生成微孔结构的氧化膜，有晶相二氧化钛和羟基磷灰石生成。电化学实验显示，微弧氧化处理前后钛试件的自腐蚀电位、自腐蚀电流密度分别为-0．358V、0．55μA／cm^2和-0．255V、0．80μA／cm^2。电化学阻抗谱证实拟合与实际测量结果一致。结论：经微弧氧化处理后，纯钛的耐腐蚀性明显提高。     

钛表面微弧氧化处理对钛瓷结合强度的影响

目的:探讨微弧氧化膜作为钛与瓷间的中间层,增强钛瓷结合强度的可行性。方法:对钛表面采用打磨光滑、喷砂处理、微弧氧化等 3种不同方法进行处理后,表面进行瓷粉烧结。根据ISO9693标准,对钛瓷间的三点弯曲结合强度进行测试,并对钛瓷结合界面和瓷剥脱面进行SEM和EDX观察与分析。以镍铬合金与瓷的结合强度测试结果为对照。结果:微弧氧化组的钛瓷结合强度与镍铬合金瓷组相比在统计学上无显著差异(P>0. 05);粗糙组的钛瓷结合强度大于光滑组(P<0. 05),但明显小于微弧氧化组 (P<0. 01)。光滑组的钛瓷界面间可见有约 25μm的裂隙;粗糙组的钛瓷界面只有在局部区域存在着少量的孔隙;而微弧氧化组的钛瓷界面瓷与钛基体结合紧密,无任何气泡、孔隙存在。结论:钛表面微弧氧化可有效地提高钛瓷的结合强度,达到镍铬合金与瓷的结合强度水平。     

微弧氧化技术提高钛-瓷结合强度的研究进展

微弧氧化(MAO)技术能够在纯钛表面形成表层多孔而内层致密的氧化陶瓷膜层,影响钛-瓷结合强度.通过优化MAO技术中电压、占空比、电流强度及氧化时间等工艺参数和电解液配方,可对纯钛表面氧化膜层的成分及结构进行改造,使其在一定程度上对钛的高温氧化性进行控制,进而达到提高钛瓷间结合强度的目的.本文重点就MAO技术提高纯钛与瓷粉之间结合强度研究进展作一综述.     

纯钛表面微弧氧化膜的结构与成分分析

目的:探讨纯钛表面应用微弧氧化技术进行改性的效果。方法:应用微弧氧化技术在纯钛表面制备陶瓷膜层,并用扫描电镜(SEM)观察其表面和横断面形貌,X射线能谱(EDS)及X射线衍射(XRD)分析其元素成分和晶相结构。结果:微弧氧化处理后,纯钛表面生成微孔结构的氧化膜,膜层厚度约20μm,由O,Ti,Ca,P四种元素组成。膜层表面有火山丘状的微孔分布,直径约0.1μm-5μm。膜层由锐钛矿型和金红石型二氧化钛及少量结晶相羟基磷灰石组成。结论:经微弧氧化技术处理后,纯钛种植体表面生成了内层致密外层多孔的晶相二氧化钛膜,含有少量羟基磷灰石。此结论可供今后开发新型口腔种植材料参考。     

不同表面形貌掺锶羟基磷灰石涂层钛种植体的体内实验研究

目的:观察不同微弧氧化时间处理对纯钛表面形成的掺锶羟基磷灰石涂层表面形貌的影响,以及不同表面形貌特征对其表面成骨特性的影响。方法:经5、10、15 min 3种微弧氧化时间在钛表形成3组掺锶羟基磷灰石涂层,分别采用扫描电镜观察表面形貌;采用表面粗糙度仪测量涂层表面粗糙度数值。然后再将3种钛种植体植入新西兰兔体内,术后4、12周取材,采用组织染色法观察植入体表面骨形成情况和骨接触率(Bone Implant Contact,BIC)。结果:随着微弧氧化时间的延长,涂层表面形貌成多孔状且越加不规则,粗糙度增加;丽春红染色显示4周时植入体表面有新骨形成,12周时转化为成熟的骨组织并与涂层形成紧密的骨结合。随植入时间的延长种植体表面骨接触率逐渐增加,而且15 min组和10 min组的骨接触率在第4周和12周均高于5 min组。结论:不同微弧氧化时间可以改变掺锶羟基磷灰石涂层的表面特性,而粗化的的涂层表面结构有利于骨组织的形成。     

Brånemark Implants and Osteoporosis: A Clinical Exploratory Study

Background: Oral implant treatment on patients with poor jaw‐bone texture has shown increased failure rates in series of studies. Purpose: The purpose of the present study was to retrospectively follow patients with osteoporosis of the axial or appendicular skeleton, including the jaw bone, being subjected to oral implant treatment. The outcome of inserted implants, when using an adapted bone site preparation technique and extended healing periods, was evaluated. Materials and Methods: Based on data obtained from preoperative radiographs, patient medical history, and resistance of the jaw bone perceived during drilling, 14 of 16 patients were referred to the Osteoporosis Laboratory, Sahlgren University Hospital, Göteborg, Sweden, for bone density measurements. Two patients already had an established diagnosis of osteoporosis. Fourteen jaws in 13 patients (11 females, 2 males; mean age:68 yr) were subsequently subjected to oral implant treatment with a total of 70 implants (Brånemark System) of various designs. The mean follow‐up period was 3 years and 4 months (range:6 mo‐11 yr). Results: Osteoporosis of either the spine, the hip, or both regions was diagnosed in 14 patients, and osteopenia was diagnosed in 2 patients. Two implants failed, and the overall implant survival rate at the end of the study period was 97.0% for maxillae and 97.3% for mandibles. The marginal bone resorption at the 1‐year follow‐up concurs with the outcome of other studies, irrespective of the preoperative bone texture present. Conclusion: The outcome of the present study showed that implant placement in patients in whom the average bone density showed osteoporosis in both lumbar spine and hip as well as poor local bone texture may be successful over a period of many years.     

两种钛种植体与骨结合界面的组织学研究

目的　对两种表面形态不同的钛种植体在不同种植时期骨结合界面情况进行研究。方法　在恒河猴下颌磨牙区分期分别植入CDIC和ITI-TPS钛种植体,采用同体对照的方法,对两种种植体与骨结合界面情况进行组织学观察。结果　口腔检查未见种植体松动及周围组织明显炎症表现。各期种植体骨界面X线影像均未见明显透射暗影,仅种植1个月的CDIC种植体颈部见少量角形吸收。光镜和扫描电镜观察见种植1个月后两种种植体骨界面有少量骨形成;1~3个月ITI-TPS种植体界面骨形成较明显,成骨量统计分析,差异有显著性;种植后1年,两者未见明显差别。结论　无载荷条件下,种植体植入后1~3个月内,ITI-TPS种植体表面骨结合形成优于CDIC种植体。随植入时间的增加,两种种植体均形成良好的骨性结合界面。     

Implants in partially edentulous patients. A longitudinal study of bridges supported by both implants and natural teeth

The aim of the study was to compare the outcome of bridges supported by implants with bridges supported by a combination of implants and natural teeth abutments. The study comprised 23 patients with Applegate Kennedy Class I dentition in the mandible and a full upper denture. Implants ad modum Brånemark were inserted in the posterior areas of both mandibular quadrants. On one side, a bridge supported by 2 implants was constructed (Type I) and on the other side, a bridge supported by 1 tooth (mostly the canine or first premolar) and 1 implant was made (Type II). A total of 46 bridges were made and during the 3-year follow-up period, 4 Type I and 2 Type II bridges were lost. 8 out of 69 implants were lost during the 3-year follow-up, resulting in an implant survival rate of 88.4%. Marginal bone loss, one of several parameters, was evaluated on standardized intraoral radiographs. This was performed during the 1st and 2nd year of function and the total mean bone loss from loading was 0.46 mm and 0.56 mm, respectively. The bone loss during the 2nd year of function was significantly less, adjacent to implants supporting Type II bridges, than adjacent to implants supporting Type I bridges. Summarily, no disadvantages of combining of teeth and implants in the same bridge were found in this study. On the contrary, the slightly lower marginal bone loss adjacent to implants in Type II bridges may indicate that the bone reactions could be more favorable when bridges 1 are connected to both implants and teeth.     

显微CT与硬组织切片技术在评价牙种植体骨结合中应用的对比研究

目的 :探讨最佳反映牙种植体表面骨结合情况的检测方法。方法 :4只beagle犬下颌骨延期植入40枚种植体,在2周和4周时取样进行显微CT检测和硬组织切片制作,对比两种检测方法的效果和特点。结果:显微CT具有连续性和完整性的优势,可以宏观地观察到种植体周围骨质情况,但是由于金属伪影的存在,它对种植体-骨界面成骨现象显示不够清晰。硬组织切片是一种单层组织切片,制作过程较复杂,但其对种植体-骨界面的细微情况显示较清晰。结论:显微CT更适用于对种植体周围总体成骨的评估,而种植体表面成骨的细微变化宜采用硬组织切片。     

Implants in relation to natural teeth

Osseointegrated implants are now an accepted part of the prosthetic treatment of edentulous patients. More recently, osseointegrated implants have been advocated in the treatment of partially dentate patients. The implants can be used in conjunction with natural teeth for the support of rigid prostheses. The natural tooth is supported in bone by a periodontal ligament, whereas the implant may be described as having a more intimate or ankylotic connection with the supporting bone. Different attachment mechanisms may lead to differential rates of destruction in both situations, particularly if teeth and implants are splinted together by a rigid prosthetic appliance. Also noteworthy are the possible differential rates of marginal tissue breakdown as a result of the influence of bacteria. Results of a pilot study in which marginal breakdown was induced around implants and natural teeth in beagle dogs suggest that the process of destruction proceeds more slowly in the case of implants. However, the disease process around implants may be more difficult to arrest due to conjectural problems in treating the surface of the implant using conventional techniques of periodontal treatment. From the limited data available so far, it would appear that osseointegrated implants can be used as predictably in partially dentate as in totally edentulous mouths. More research should be initiated on the potential for tissue-breakdown, and long-term maintenance of the marginal tissues around implants.     

Melatonin as a pro‐osteogenic agent in oral implantology: a systematic review of histomorphometric outcomes in animals and quality evaluation using ARRIVE guidelines

The aim of this review was to evaluate the outcomes of preclinical trials that assessed the use of melatonin as a pro‐osteogenic agent in the field of oral implantology. Melatonin is a hormone that has been shown to have beneficial antioxidant and bone‐metabolic effects. A number of experimental studies have analysed its effect in promoting osseointegration around dental implants in animals. A bibliographic search in PubMed, Scopus and EBSCOhost was performed. Animal studies that quantitatively analysed the pro‐osteogenic effect of melatonin were included. Quality assessment of the included studies was performed using the ARRIVE guidelines. Eight studies met the inclusion criteria. The experimental animals used were dogs, rabbits and rats. Melatonin was used in a lyophilized powdered form, an injectable form or as a dipping solution. Six of the eight studies included showed a statistically significant positive effect of melatonin on bone–implant contact and various other histomorphometric parameters. The ARRIVE criteria were generally well reported by the included studies (17.5 ± 1.60/24), although several criteria (including randomization and blinding) were poorly documented, with most of the studies showing a high/unclear risk of bias. The majority of the studies included showed a statistically significant positive effect of melatonin on bone formation around implants. However, the clinical significance of this effect was unclear given the high/unclear risk of bias in the majority of included studies. Given the limited amount of data available, further research should be conducted to evaluate the clinical potential of this pineal hormone in clinically relevant situations, such as compromised sites or patients.     

Rates of Osseointegration of Dental Implants With Regard to Anatomical Location

PURPOSE: Implantation of commercially pure titanium dental implants can be obtained predictably and consistently. The initial research focused on the edentulous population, with most of the fixtures being placed into the anterior mandibular area. There has been increased use of dental implants for partially edentulous patients. MATERIALS AND METHODS: This study reports the results of 169 consecutively treated patients with 673 fixtures. Patients were observed for 7 months to 8 years following occlusal loading. RESULTS: Implant osseointegration was 89.1% in the anterior maxillae; 71.4% in the posterior maxillae; 96.7% in the anterior mandible; and 98.7% in the posterior mandible. CONCLUSION: Osseointegration may be most dependent on anatomical location in the jaws.     

Occlusal Rehabilitation Using Implants for Orthodontic Anchorage

Osseointegration is defined as a direct interaction of bone to an implant surface. As a result, the implant fixture is immobilized in the bone and lends itself to function as an anchor for orthodontic tooth movements. When properly treatment-planned, these implants can also be used as prosthodontic abutments for single crowns, or removable or fixed partial dentures. This article describes how implant fixtures were surgically placed within the maxillary and mandibular arches of a partially edentulous patient, and used for orthodontic anchorage to reposition the remaining teeth into a more favorable arch position, creating increased posterior interocclusal space. The fixtures were then restored with fixed partial dentures to rehabilitate the patient into a mutually protected occlusion.