两种钛种植体骨界面SEM观察和电子探针元素分析

目的：研究钛种植体的两种表面形态与其骨结合界面的关系。方法：在猴下颌磨牙区分期分别植入CDIC和ITI-TPS钛种植体,对界面进行光镜、扫描电镜观察和电子探针元素分析。结果：光镜和扫描电镜观察,种植后1个月的界面只有少量的骨形成;1～3个月的ITI-TPS种植界面的骨形成较CDIC者明显;种植后1年,二者未见明显差别。元素分析,界面钛、钙、磷相互渗透,各期ITI-TPS界面钛的渗透密度均较相应时期CDIC者高。结论：埋植后1～3个月,ITI-TPS种植体骨整合性优于CDIC种植体,但随时间的延长,两种种植体均可形成良好的骨性结合界面。ITI-TPS种植体渗透至界面周围组织的钛离子多于CDIC种植体者。     

生物活性陶瓷涂层钛复合种植体—骨界面的形态学研究

本文从肉眼、X线拍片、组织学切片、扫描电镜及X线能谱观察并分析与两种生物活性玻璃陶瓷(BGC)涂层钛种植体—骨界面有关的材料变化及组织反应。结果表明:(1)两种涂层种植体的涂层具有轻微的生物降解性,有利于促进界面骨代谢,引导骨生长,加速形成界面的骨性结合。(2)两种涂层种植体—骨界面区的组织侧的钙化活跃期在种植3个月之内,材料侧的钙磷离子溶出主要发生在种植后3个月之内。     

钛板携带种植体修复下颌骨缺损的动物试验

目的：观察钛板与种植体联合植入修复羊下颌骨缺损的生物反应和X线表现。方法：12只山羊下颌骨单侧和双侧体部切除后,将特制的装有HA涂层种植体的钛板植入骨缺损区,并在种植体周围植松质骨。术后给抗生素预防感染。3个月后安装基台和义齿,行X线拍片观察钛板和种植体与骨接触区的愈合情况及羊的饮食和生存情况。6个月后植骨区和骨断端与钛板界面处取材行组织学观察。结果：钛板携带种植体植入羊下颌骨后未见感染和排异反应,伤口一期愈合。安装基台和义齿后给羊喂粉碎的饲料,未见伤口裂开和钛板脱落。3个月后X线拍片见在种植体周围存在新骨,钛板与下颌骨紧密相连。6个月后镜下见种植体周围为不规则的骨小梁结构和纤维组织。结论：钛板携带种植体植入羊下颌骨后无明显排异反应,可恢复羊下颌骨的外形和咀嚼功能。     

组织工程化骨修复兔下颌骨缺损同期种植体植入的实验研究

目的　观察组织工程化骨修复兔下颌骨缺损同期进行HA/SLA Ti或SLA Ti种植体植入后,种植体与骨床发生骨结合的情况。方法　兔BMSCs复合nHAC及PRP用于修复兔下颌骨颊侧范围为15 mm×15 mm的全层骨缺损,同期分别植入HA/SLA Ti种植体（A组）和SLA Ti种植体（B组）。术后1、3、6个月取材,进行大体标本观察、扫描电镜观察、组织学检查及种植体的推入实验和拉出实验。结果　大体标本观察显示,A组术区逐渐由新生骨组织修复,种植体周围形成较完善的骨结合界面,界面骨成熟;B组术区骨愈合状态佳,但种植体周围仍存在少量纤维组织。扫描电镜结果显示：A组种植体较B组种植体与周围新生骨结合的更紧密。组织学检查的结果显示,A组新生骨与种植体表面直接结合,骨形成较B组种植体表面骨形成提前,B组种植体与新生骨之间存在纤维组织。推入实验和拉出实验结果显示,术后1个月时A、B两组种植体的推入应力和拉出负荷无明显差异,术后3个月后A组种植体的推入应力和拉出负荷明显较B组提高,差异具有统计学意义。结论　修复兔下颌骨缺损的组织工程化骨内同期植入的种植体,可与新生的骨组织形成良好的骨结合,其中HA/SLA Ti种植体的骨结合能力较SLA Ti种植体强,且骨愈合时间也较后者提前。     

生物陶瓷涂层复合种植体骨界面的剪切强度

本文以恒河猴为实验对象,以未涂层纯钛种植体为对照,用力学测试方法研究两种生物活性玻璃陶瓷涂层种植体植入股骨后,种植体——骨界面的剪切强度。结果表明:两种生物活性玻璃陶瓷涂层种植体,与未涂层种植体相比,在种植早期较快与骨形成牢固的结合。其中,又以M—涂层种植体更明显,它的平均界面剪切强度,在种植后3个月是未涂层者的2至3倍。     

影响纯钛种植体骨整合界面形成的临床因素分析

目的 通过临床实践探讨影响钝钛种植体骨整合界面形成的因素,寻求防治措施,提高种植义齿的成功率。方法 对230例门诊种植病人采用Branemark纯钛种植体行延期种植术,3～6个月后行Ⅱ期手术。结合X线及术中所见,评价钝钛种植体骨整合界面形成状况。结果 在植入的520颗纯钛种植体中,获得骨整合界面的有503颗,失败17颗,成功率96.7%。结论 影响纯钛种植体骨整合界面形成的因素有术前严格选择适应证及充分的术前准备,防止骨灼烧,预防感染,防止术中种植体被污染。     

氮化硅复合种植体-骨界面的剪切强度

目的：测试并分析新型种植体及钛种植体与骨的剪切强度。方法：以Ｂｅａｇｌｅ犬为实验对象,羟基磷灰石（ＨＡ）涂层钛种植体及钛合金种植体为对照,用力学测试方法研究新型种植体－氮化硅复合羟基磷灰石涂层种植体和单一氮化硅种植体植入股骨后,不同时期种植体－骨界面的剪切强度。结果：两种有涂层的种植体植入后１个月,其界面剪切强度高于非涂层者,但３个月后实验组的两种种植体界面剪切强度明显高于对照组,与骨形成更牢固的     

CDIC和ITI纯钛种植体周围骨组织生物学基础研究

目的：应用MicroCT、光学显微镜评价国产CDIC和ITI纯钛种植系统与周围骨组织整合的差别。方法：拔除狗的第一、第二磨牙,4个月后应用国产CDIC和ITI种植体植入,同体对照,术后4月、12月处死动物,分别取含种植体的组织块,MicroCT成像建立三维模型后,不脱钙切片甲苯胺蓝染色行光学显微镜对比观察。结果：①.两组种植体均被机体耐受,周围的骨组织均未发现炎症细胞和巨大细胞②.MicroCT、光学显微镜观察均显示ITI比CDIC种植体新骨形成早、量多,一年之后两者骨组织形成量没有显著差别。③MicroCT和光学显微镜对种植体周围骨组织微结构的研究结果具有正相关性。结论：使用国产CDIC种植系统与ITI种植系统骨结合基本相同,在临床上能获得较高的成功率。MicroCT分辨率高,能够建立高清晰三维图像,是对种植体周围骨组织研究的一种准确有效的新方法。     

钛种植体与单纯珊瑚及复合BMP珊瑚代用品结合的实验研究

目的　研究单纯珊瑚与复合BMP的珊瑚表面贴附移植后与同期植入的钛种植体形成骨结合的情况。方法　将单纯珊瑚与复合BMP的珊瑚置于去皮质的犬髂骨表面 ,同时植入钛种植体 ,用种植体固定人工骨 ,不同时间取材 ,观察种植体与人工骨的骨结合情况。结果　种植体与单纯珊瑚与复合BMP的珊瑚均可以形成骨结合。单纯珊瑚 12周时 ,种植体与珊瑚之间形成结构不规则的骨界面 ;同时 ,材料有大量的吸收。珊瑚复合BMP时新骨明显增多 ,形成粗的骨小梁 ,骨髓腔变小 ,6周时与种植体之间已经形成基本完善的骨界面 ;且材料总体吸收量较少。结论　天然珊瑚具有良好的生物相容性 ,可以与钛种植体形成骨性结合 ;BMP、珊瑚复合材料植入可以加快成骨 ,延缓吸收。此复合材料可以应用于种植外科     

在移植骨上延期种植的实验研究

目的论证冷冻自体下颌骨复合髂骨移植后延期种植的可行性。方法16只成年雄性杂种狗，制备下颌骨双侧骨缺损，左侧行冷冻自体下颌骨骨块的原位再植并结合髂骨松质骨移植，即复合移植组（composite transplantation group，CTG），右侧缺损行自体髂骨块移植即髂骨移植组（iliac transplantation group，ITG），术后3个月分别在两类骨块上植入IMZ TPS种植体，种植体植入后3、6、9、12周分别处死4只动物取材，采用数字化X线片对种植体与颌骨结合界面进行灰度定量分析，组织学观察种植体．骨结合情况。结果各期种植体周围均未见吸收性骨质密度减低影像。骨一种植体界面灰度定量分析显示，种植体植入两类移植骨3、6和9周时，其界面骨质密度改变差别明显，复合移植组明显优于髂骨移植组；种植体植入12周时，两组界面骨质已无明显差别，两类移植骨均与种植体有良好的骨结合，其骨愈合方式基本相同。结论冷冻自体下颌骨复合移植修复下颌骨缺损并延期植入牙种植体后，二者可形成良好的骨结合。     

前牙缺失早期加载种植修复

目的 观察CDIC一段式种植体用于前牙缺失的早期修复效果。方法 70例患者分为两组，实验组：种植术后1周即行上部结构修复，对照组：按常规术后6个月行牙冠修复，修复材料为釉质瓷及金属烤瓷，观察指标包括种植体动度、X线改变和修复体性能。结果 随访0．5－2年，实验组与对照组临床成功率及牙槽嵴吸收率无明显差异。结论 CDIC种植体植入后，在无He创伤情况下，可直接进行早期、永久性牙冠修复，从而缩短修复周期，满足患者的要求。     

Implants placed in an irradiated dog mandible: a morphometric analysis

The objective of this research was to evaluate the influence of radiotherapy on the osseointegration of oral implants in a canine model. After the extraction of all mandibular premolars and first and second molars, 11 male beagles were divided into 3 groups. The control group (3 dogs) received no radiation. The second group (4 dogs) was irradiated 4 weeks after implantation. The third group (4 dogs) was irradiated 8 weeks before implantation. Eight implants were placed in each dog, in an alternating pattern: 4 non-submerged ITI Bonefit titanium plasma spray-coated and 4 submerged Steri-Oss hydroxyapatite-coated. The irradiated dogs received 4.3 Gy daily for 10 days. After 6 months of osseointegration, the dogs were sacrificed and each hemimandible was dissected to isolate the implants. Quantification of the extent of the direct bone-implant contact was carried out by scanning electron microscopy backscattered electron images that reproduced each implant in its entirety, using a digitizing table connected to a computer. The results were expressed as a percentage of direct bone-implant contact versus total perimeter accessible to bone. The bone contact percentage for the control group was 87% for Steri-Oss implants and 69% for the ITI Bonefit implants; for the animals irradiated after implantation, the percentages were 82 for Steri-Oss implants and 58 for ITI Bonefit implants; and for the animals irradiated before implantation, the percentages were 62 for Steri-Oss implants and 28 for ITI Bonefit implants. A statistically significant difference appeared between the 2 types of implants (P < .001). A statistically significant difference was also seen between the 3 groups for both types of implants, except between the control group and the group irradiated after implantation (P = .14). This indicates that, overall, the timing of irradiation influences osseointegration. Osseointegration is possible before and after radiotherapy; however, the direct bone-implant contact increased when the implants were placed before irradiation.     

A three-year follow-up report of a comparative study of ITI Dental Implants and Brånemark System implants in the treatment of the partially edentulous maxilla

Background: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1‐year report of a comparative study of ITI Dental Implant System® implants (Straumann AG, Waldenburg, Switzerland) and Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3‐year follow‐up of that randomized study. Purpose: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Branemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level. Material and Methods: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Brånemark implants or ITI implants; 77 ITI implants and 73 Brånemark implants were inserted. After 6 months abutment connections were made to both ITI and Brånemark implants. All patients were provided with fked partial prostheses of gold‐ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years. Results: Two Brånemark implants and two ITI implants were lost. The Brånemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Brånemark implants was situated 1.8 mm from the reference point at both the baseline and the 3‐year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Brånemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Brånemark implants. This difference was statistically significant. Conclusions: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems.     

被动吸烟对大鼠种植体周围骨沉积的影响

目的:探讨被动吸烟对大鼠种植体周围骨沉积的影响.方法:全麻下在32只Wistar大鼠右侧胫骨内植纯钛螺纹状种植体,根据不同的被动吸烟时间将大鼠随机分为3组,即对照组、被动吸烟中止组和被动吸烟持续组,3个月后行DEXA骨密度测量仪检测骨密度,而后处死动物获取胫骨标本,扫描电镜观察各组种植体骨界面骨组织生成情况;实验数据用...     

Effect on the amount of bone-implant contact when splinting immediate-loaded dental implants

PURPOSE: Much attention has been focused on the immediate or early loading of implants with or without splinting. The purpose of this study was to evaluate the contact rate between bones and implants, with or without splinting. MATERIALS AND METHODS: Under general anesthesia, an 8-mm-deep cavity for a dental implant was drilled in the mandibular ridge of dogs where teeth had been extracted 4 months earlier. Rough-surfaced, cylindrical screw implants (International Team for Implantology [ITI] monotype implants 4 mm diameter and 8 mm long, Straumann, Basel, Switzerland) were placed with splinting on the right side and without splinting on the left side using gold abutment. Resin plates for the maxilla were adjusted to attach to the gold abutment in each mandible. At 4, 8, or 12 weeks after the implantation, specimens were stained using toluidine blue and fuchsin. The sections were observed and morphometric analysis was performed to measure the rates of bone-implant contact and new bone-implant contact. RESULTS: The ratio of bone-implant contact on the lingual side was higher than on the buccal side in both the splinted and the unsplinted groups, and the rates in the splinted group were also higher than in the unsplinted group. The ratio of new bone-implant contact was not significantly different between the splinted and unsplinted groups, except for spongy bone at 4 weeks. CONCLUSION: Splinting of immediate-loading dental implants can be adequate for osseointegration, particularly in spongy bone.     

Nonsubmerged and submerged implants in the treatment of the partially edentulous maxilla

Background: Dental implants vary in design and surfaces. In addition, different surgical techniques have been used for implant insertion. The ITI Dental Implant System (Straumann AG, Waldenburg, Switzerland) has always required a one‐stage technique, whereas the Brånemark System (Nobel Biocare AB, Gothenburg, Sweden) requires a two‐stage technique. Purpose: The aim of this study is to compare the outcome of fixed partial bridges in the maxilla supported by both ITI and Brånemark implants in a split‐mouth design. Materials and Methods: Twenty‐eight patients with a residual anterior dentition in the maxilla were included in this split‐mouth study. The Brånemark implants were used on one side and the ITI implants on the other side of the residual dentition according to a randomization procedure. A blocking size of four was used, giving equal probability of placing ITI or Brånemark implants in the right or left side of the jaw. The surgical and prosthetic procedures followed the guidelines given by the manufacturers. The prosthetic treatment with the two‐implant systems was performed at the same time, and for that reason the healing period was 6 months for both systems. The observation period for all patients was 1 year after loading. Results: Two Brånemark implants (in one patient) were lost before loading, and one ITI implant was lost 1 year after loading. There was no significant difference in survival rate. Radiographie examination of the bone level was performed at the time of delivery of the bridge and after 1 year. The mean marginal bone level at baseline was situated 1.9 mm from the reference point for the Brånemark implants and 1.5 mm for the ITI implants. With regard to the insertion depth used, these bone levels indicate that bone loss had taken place before baseline. However, between baseline and the 1‐year examination, there was no significant change of the marginal bone (0.2 ± 0.08 mm at the Brånemark implants and 0.1 ± 0.11 mm at the ITI implants). The difference between results with the two implants was not statistically significant. Crater‐form bone destructions were seen at some ITI implants, indicating periimplantitis. However, at only two implants were there clinical signs of periimplantitis. Conclusions: No significant difference in survival rate or in marginal bone change could be demonstrated between the two systems. At some ITI implants (18%), crater‐form bone loss was observed.     

Immediate loading with complete implant-supported restorations in an edentulous heavy smoker: histologic and histomorphometric analyses

The clinical case presented is that of an edentulous female patient, a heavy smoker, who received implant-supported complete restorations in the maxilla and mandible using the immediate loading concept according to the Ankylos implant system. The patient received 12 commercially pure titanium (grade 2) Ankylos implants, 6 in the maxilla and 6 in the mandible. The implants were loaded immediately after surgery with temporary acrylic resin prostheses fabricated chairside using a prefabricated customized splint. The definitive ceramometal restorations were seated 4 months after surgery. Clinical and radiologic evaluation at 7 months after implant placement indicated functional bone anchorage of all implants, despite the patient being a smoker and having poor bone quality. The patient died 7 months after implant placement because of lung cancer; however, there was no known disease at the time of implant placement. After her death, the implants with the surrounding tissues were removed en bloc and examined histologically and histomorphometrically using undecalcified cut and ground sections. All implants were osseointegrated to some extent and surrounded by lamellar bone. However, around the upper, nonthreaded parts of the implants, much of the bone had been resorbed. In this region, fibrous connective tissue was in close contact with the titanium surface. Epithelial proliferation with pocket formation could not be observed in any of the implants. The histomorphometric evaluation of bone-implant contact in threads demonstrated a mean of approximately 51% of the available surface and a mean bone volume of approximately 52%, with a tendency toward greater contact and volume around the implants in the maxilla. If the nonthreaded cylindric portions of the implants were included, mean bone-implant contact was 46% and mean bone volume was 47%.