改良喷砂钛种植体表面加快骨愈合的细胞学研究

目的　体外研究改良喷砂表面对成骨细胞功能、分化的影响 ,从细胞水平揭示该表面促进骨愈合的作用机制。方法　成骨细胞为原代分离、培养的第 5代人胚成骨细胞 ,选择细胞层碱性磷酸酶 (alkalinephosphatase,ALP)活性、蛋白质含量以及培养液中骨钙素含量作为评价成骨细胞功能、分化的 3项指标。采用酶动力法检测ALP活性、采用考马斯亮蓝法测定蛋白质含量、采用放免测定技术检测骨钙素含量 ,所得各值进行标准化处理。实验分 3组 :改良喷砂表面组、光滑表面组和细胞培养板空白对照组 ,细胞培养取 4d和 1 3d两个时间点。结果　细胞培养 4d ,改良喷砂表面组细胞层ALP活性 [(1 7 390± 1 59)nmolPNP·min- 1 ·1 0 - 6 个细胞 ]、蛋白质含量 [(1 52 7± 1 6 3) μg/1 0 6个细胞 ]以及培养液中骨钙素含量 [(43 0± 6 1 )ng/1 0 6 个细胞 ]均明显高于光滑表面组 [分别为(1 0 978± 1 879)nmolPNP·min- 1 ·1 0 - 6 个细胞、(58 0± 5 9) μg/1 0 6 个细胞及 (2 4 9± 6 0 )ng/1 0 6 个细胞 ]。培养至 1 3d ,各项指标两组间差异消失。结论　从细胞学角度证明改良喷砂表面具有加快种植体骨愈合的作用 ,该作用是通过促进成骨细胞分化和功能表达实现的     

电磁场对商业纯钛种植体周围骨愈合影响的组织学和力学研究

脉冲电磁场(PEMF)已成功用于治疗骨科中的假关节病和不愈合性骨折。一些研究提示：在口腔种植手术后运用脉冲电磁场治疗有利于种植体周围骨愈合。有关PEMF促进骨愈合的机制还未完全阐明，但认为PEMF能促进组织血管化、胶原生成和骨原细胞的增殖分化。迄今为止，几乎所有     

纯钛表面吸附硫酸软骨素A对成骨细胞生长的影响

目的 在体外研究纯钛表面吸附硫酸软骨素A(Chondroitin Sulfate—A,CS—A)后对成骨细胞生物学行为的影响。方法 在吸附不同浓度的CS—A钙处理钛片表面培养成骨细胞，检测其生长情况、碱性磷酸酶活性及细胞层钙含量。结果 钙处理钛片在吸附CS—A后促进了成骨细胞的增殖。增加了成骨细胞层钙聚集，促进成骨细胞的矿化，同时还增高了成骨细胞的碱性磷酸酶活性，促进了细胞的分化。结论 钛吸附CS—A后提高了其生物相容性。     

He—Ne激光影响纯钛种植体骨性愈合的实验研究

目的：探讨He-Ne激光对种植体骨性愈合影响。方法：将24只白兔手术暴露双侧胫骨内侧,每侧胫骨内植入直径2mm,高5mm纯钛种植体4棵。术后随机选一侧每天用15J/cm^2He-Ne激光照射术野15分钟为实验组, 另一侧为对照组,于照射后第1、2、3、4周各处死6只动物。行种植体界面光镜、电镜观察及成骨量定量分析。结果：光镜及电镜观察显示实验组中骨胶原纤维、骨小梁、成骨细胞、破骨细胞、钙盐沉积均比对照组较早出现。数量也明显增多。定量组织学分析除术后2周外,成骨量实验组均比对照组显著性增加。结论：He-Ne激光可作为促进种植体骨性愈合的一种治疗方法。     

增龄变化对钛种植体骨结合影响的实验研究

目的探讨增龄变化对钛种植体骨结合的影响，为临床判断种植预后提供理论依据。方法选择雄性SD大鼠36只，随机分成青年群、成年群和老年群，在双侧胫骨内侧窝距关节0．5cm处分别植入钛种植体2颗。三组大鼠分别在术后14天、28天、56天随机各处死4只，摘取胫骨，制作带种植体的非脱钙硬组织切片，观察组织学变化，计算骨结合率。结果青年群的成骨能力最强，种植体与骨的结合连续、紧密，成年群次之，老年群最差。老年群成骨量及骨接触率均低于青年群和成年群。以上情况对松质骨影响大，对皮质骨影响小。结论增龄变化可影响钛种植体与骨组织的结合，种植体周围新骨形成量及骨结合率随年龄增长而降低。     

钛种植体表面处理对骨整合的影响

钛种植体表面处理如机械及微机械加工,喷砂酸蚀,微弧氧化,表面纳米化和生物化学方法都会促进种植体的骨整合能力.本文就钛种植体的表面处理对骨整合的影响作一综述.     

高脂血症对钛种植体骨结合影响的研究进展

高脂血症是常见的全身代谢性疾病,中老年人多见,发病率较高。高脂血症是种植治疗的风险因素之一,可引起种植体骨结合不良,从而影响种植义齿的临床疗效。本文针对高脂血症对钛种植体骨结合影响的研究进展作一综述。     

钛种植体-骨间隙愈合界面成骨方式的激光共聚焦显微镜观察

目的：观察钛种植体一骨界面的新生骨形成情况,探讨在间隙愈合模型中种植体和骨表面是否存在双向成骨现象。方法：将4枚带有环形凹槽的纯钛种植体经喷砂、酸蚀处理后,植入兔股骨远端髁突内。术后第5d和第19d分别肌肉注射钙黄绿素和茜素红。采用激光共聚焦显微镜观察带种植体的硬组织切片。结果：激光共聚焦显微镜显示,种植体的间隙区域均有新生骨组织生成。在间隙区域,骨创面和相应的种植体表面分别存在绿色荧光带（钙黄绿素）,二者问不连续,而在19d时注射的茜素红所标记的红色荧光将二者连接融合,并可见大量红色荧光分布于绿色荧光周围。结论：种植体一骨界面存在远端成骨和接触成骨2种成骨方式,二者相向成骨。     

硫酸软骨素应用于骨修复材料中的研究进展

硫酸软骨素是细胞外基质(extracellular matrix, ECM)的重要组成部分。近年来,硫酸软骨素被证实在生物医学应用中具有潜在的功效,已被广泛应用于骨再生和骨修复治疗,尤其是在颅面修复和牙科医学领域。研究表明,硫酸软骨素衍生物及硫酸软骨素复合支架在促进成骨和生物矿化方面显示出极大的潜力。但是,由于硫酸软骨素种类繁多,应用形式广,对硫酸软骨素成骨修复机制的研究仍然存在不足。该文就硫酸软骨素的生物学特性、成骨修复作用、不同生物材料设计中的应用及未来展望进行阐述。     

钛膜引导骨再生在骨内种植体植入中的应用

目的：总结牙种植术后使用钛膜引导骨再生临床体会。方法：对30例47枚牙种植术中发现骨缺损、骨量不足的患者采用钛膜进行骨引导再生修复骨缺损及骨增量。术后定期观察，对新骨生长情况进行连续临床和X线的观察分析。结果：30例47枚牙种植术中，39枚种植体植入部位使用了钛膜。二期手术时种植体均已与骨组织形成理想的骨融合，顺利完成种植义齿修复。39枚种植体中有15枚种植体术后2个月的X线片可见到种植体封闭螺帽上方骨密度增高影。4月后二期手术切开牙龈时可见到新骨覆盖种植体表面，以骨凿等去除新骨后方可见到封闭螺帽。结论：医用钛膜在种植术中应用有较好的引导骨再生作用，有利于种植术后骨融合期新骨的形成。不可吸收性膜的一些固有缺陷可通过临床正确的设计关在术中严格按照操作要点进行手术，可获得理想的骨再生效果。     

Radiographic evaluation of crestal bone levels adjacent to nonsubmerged titanium implants

Several parameters have been described to determine success or failure in long-term evaluations of dental implants. One of these parameters is the observation of changes in peri-implant bone levels. Studies on submerged implants have analyzed the bone level changes in the pre- and post-loading phases. No such data exist for intentionally nonsubmerged implants. The purposes of this study were: (1) to test the applicability and reproducibility of a simple computer-assisted method in the evaluation of changes in peri-implant bone levels; (2) to establish a baseline for the longterm radiographic follow-up; and (3) to evaluate changes in crestal bone levels adjacent to nonsubmerged ITI implants between the 1-year and 2-year examination. Standardized periapical radiographs were obtained from 80 implants at the 1-year and 2-year follow-up examinations after their placement. The implants were located in different jaw areas of 55 patients and supported single crowns or short-span fixed partial dentures. For each implant, the distance from implant shoulder to first crestal bone contact (DIB) was measured at the proximal surfaces with a digitizer/computer assembly. Statistically significant greater mean DIB were found at the 1-year (baseline) evaluation for: (1) maxillary sites overall (4.10 x 1.02 mm (SD)) compared with mandibular sites overall (3.61 +/- 1.03 mm); (2) maxillary anterior sites (4.08 +/- 0.97 mm) compared with mandibular posterior sites (3.60 +/- 1.05 mm); and (3) maxillary posterior sites (4.13 +/- 1.12 mm) compared with mandibular posterior sites. No statistically significant changes in DIB occurred in any of the jaw locations between the 1-year and 2-year evaluations.(ABSTRACT TRUNCATED AT 250 WORDS)     

Disaccharide analysis of chondroitin sulfate in peri-implant sulcus fluid from dental implants

We collected peri-implant sulcus fluid by capillary tubes from sites around titanium osseointegrated implants and determined the chondroitin sulfate released into the peri-implant sulcus fluid by high-performance liquid chromatography. Chondroitin sulfate was found in all peri-implant sulcus fluid samples, and its content was similar to that in gingival crevicular fluid obtained around natural teeth. The predominant unsaturated disaccharide isomer was ΔDi-OS, followed by ΔDi-4S. ΔDi-6S was present in trace amounts. The amount of ΔDi-OS was greater in peri-implant sulcus fluid than in gingival crevicular fluid. Assaying chondroitin sulfate disaccharides in peri-implant sulcus fluid may be an effective method of monitoring the peri-implant condition of dental implants.     

矫形力对羟基磷灰石涂层的钛支抗种植体骨界面影响的研究

目的：了解在矫形力作用下的HA涂层钛种植体骨界面情况。方法：在狗下颌骨延期植入8枚种植体，施以2.9N和5.9N的矫形力，通过三色荧光标记和组织学切片的形态学研究支抗种植体骨界面情况。结果：HA涂层钛支抗种植体在矫形力作用3个月后仍然稳定，种植体界面为骨整合,2.9N与5.9N矫形力对种植体周围骨改建的影响无差别。结论：HA涂层种植体在短期内受矫形作用下稳定，可用做正畸矫开支抗。     

A novel implantation model for evaluation of bone healing response to dental implants: the goat iliac crest

Objectives: Despite the availability of numerous animal models for testing the biological performance of dental and orthopedic implants, the selection of a suitable model is complex. This paper presents a new model for objective and standardized evaluation of bone responses to implants using the iliac crest in goats. Material and methods: The feasibility of the iliac crest model regarding anatomy and implant positioning was determined using two cadaveric specimens and the bone structure was evaluated and compared with that of the goat femoral condyle. Additionally, the validity of the model was tested by performing an in vivo study. Results: By means of a rather simple, safe, fast and reproducible surgical procedure, the iliac crest in goats could be approached and allowed the implantation of maximally five dental implants per iliac crest. Because of the bilateral implantation possibility, statistical comparisons between groups on either side of the goat could be performed, resulting in a high statistical power, and hence a reduction in the number of animals required to obtain significant data. Conclusions: In terms of surgical approach, anatomy and implant positioning, the iliac crest is the preferred model over the femoral condyle model. The iliac crest implantation model is suitable for evaluation of the osteogenic response to bone implant materials and represents a justified and deliberate alternative to the already existing animal models. To cite this article:
Schouten C, Meijer GJ, van den Beucken JJJP, Spauwen PHM, Jansen JA. A novel implantation model for evaluation of bone healing response to dental implants: the goat iliac crest.
Clin. Oral Impl. Res. 21 , 2010; 414–423.
doi: 10.1111/j.1600‐0501.2009.01872.x     

Effect of membranes and porous hydroxyapatite on healing in bone defects around titanium dental implants. An experimental study in monkeys.

The purpose of the present study was to examine the effect of treating bony craters around titanium dental implants with polytetrafluoroethylene membranes PTFE, with and without grafting of hydroxyapatite (HA), and with HA alone. 4 standardized bone defects were prepared in the alveolar ridge of edentulous areas in each of 7 monkeys. A titanium implant was then placed centrally in each defect, and in each monkey, the defects were treated with 1 of the following 4 treament modalities: 1 coverage with PTFE membrane;(2) grafting of HA and covering with a PTFE membrane;(3) HA grafting;(4) no treatment. Following a healing period of 12 weeks, all animals were sacrificed and mesiodistal ground sections of the treated areas were prepared. The histological analysis showed that all bone defects around the implants treated with PTFE membranes and 5 of the defects treated with HA and PTFE membranes were completely filled with new bone. The defects treated with HA alone and the control defects with no treatment only demonstrated new bone formation in the bottom of the defects. The results suggest that bone defects around titanium implants can be 1 treated successfully with PTFE membranes.     

Ion implantation: surface treatment for improving the bone integration of titanium and Ti6Al4V dental implants

Dental implants subjected to surface treatment have shown better bone integration than implants which have only been turned (machined). Three main types of treatment are presently available: the addition of material or coating, the removal of material, and surface modification. Ion implantation corresponds to the third approach. A histomorphometric study is made following the rabbit tibial bone placement of 88 commercial dental implants of pure titanium and Ti6AI4V subjected to surface treatment in the form of different ion implants (C+, CO+, N+, Ne+). Light microscopic, scanning electron microscopic (SEM), electron microsonde (EDS) and X-ray photoelectron spectroscopy (XPS) studies were made. The results indicate improved bone integration (expressed as percentage bone-implant contact) in those specimens subjected to ion implantation versus the non-treated controls, the difference being statistically significant for the groups treated with C+ and CO+. In these groups, XPS showed a Ti-O-C junction (bone-implant interface) involving covalent type bonds, these being stronger and more stable than the ion-type bonds usually established between the titanium oxide and bone.