Surface Roughness of Dental Implant and Osseointegration

IntroductionDental implants are a usual treatment for the loss of teeth. The success of this therapy is due to the predictability, safety and longevity of the bone–implant interface. Dental implant surface characteristics like roughness, chemical constitution, and mechanical factors can contribute to the early osseointegration. The aim of the present article is to perform a review of the literature on surface roughness of dental implant and osseointegration.MethodologyThis work is a narrative review of some aspects of surface roughness of dental implant and osseointegration.ConclusionDespite technological advancement in the biomaterials field, the ideal surface roughness for osseointegration still remains unclear. In this study about surface nanoroughness of dental implant and osseointegration, the clinical relevance is yet unknown. Innovative findings on nanoroughness are valuable in the fields of dental implantology, maxillofacial or orthopedic implant surfaces and also on cardiovascular implants in permanent contact with patient’s blood.     

雷奈酸锶对骨质疏松时种植体骨结合的影响

目的:研究雷奈酸锶治疗对骨质疏松时种植体骨结合的影响。方法:36只雌性SD大鼠随机分成骨质疏松组(A组,行双侧卵巢手术)、雷奈酸锶低剂量治疗组(B组,同A组手术)、 雷奈酸锶高剂量治疗组(C组,同A组手术)(n=12),骨质疏松模型造模成功后,在SD大鼠右侧胫骨近中干骺端植入羟基磷灰石涂层种植体,同时B组给予雷奈酸锶450 mg·kg^-1·d^-1口服,C组给予雷奈酸锶900 mg·kg^-1·d^-1口服,种植术后12周,处死动物,标本制作不脱钙硬组织标本,行形态学、显微CT观察及骨计量学检测。 结果:种植术后12周,B、C组种植体周骨密度、种植体骨结合率、新生骨量均显著高于A组(P<0.01),但C组与B组比较,各项指标差异不显著。结论:雷奈酸锶应用可拮抗骨质疏松的负面影响,促进种植体愈合,使种植体骨结合率增加。     

纳米羟基磷灰石修复种植体周围骨缺损的实验研究

目的:探讨纳米羟基磷灰石材料在种植修复中的作用.方法:将纳米羟基磷灰石植入钛种植体周围的骨缺损区,观察种植体与骨界面的结合形式和程度.结果:纳米羟基磷灰石修复钛种植体骨缺损处实现良好的骨结合.结论:纳米羟基磷灰石材料的使用在实现钛种植体与周围健康骨组织的骨结合过程中起着重要的作用.     

骨康散对骨质疏松症种植体周围骨结合影响作用实验研究

目的：观察中药骨康散Ⅱ号对去势大鼠(骨质疏松模型)骨的代谢及种植体与骨结合情况。方法：制作去势大鼠(骨质疏松模型)模型，植入种植体，同时给予骨康散Ⅱ号灌胃，观察骨康散Ⅱ号对种植体周围骨代谢、骨微观结构的影响。结果：实验组去势大鼠较对照组血中骨钙素水平显著性下降；骨与种植体结合更连续，紧密，矿化程度更高。结论：骨康散Ⅱ号能有效抑制去势大鼠高转换型骨量丧失，促进种植体周围新骨的形成和矿化。缩短种植体与骨的愈合时间，提高骨结合的质量，对闭经期骨质疏松有一定的治疗作用。     

种植体表面修饰影响骨结合机制研究进展

<正>钛及其合金具有化学稳定性高,弹性模量等力学性能与骨组织比较匹配等优点,是广泛应用的人体硬组织修复材料。钛及其合金本质上是生物惰性     

Clinical evaluation of implant survival based on size and site of placement: A retrospective study of immediate implants at single rooted teeth sites

Objectives

This retrospective clinical study sought to evaluate the survival of immediate implants placed at maxillary and mandibular single-rooted tooth extraction sites and to determine the relationship among implant size, placement site, and implant survival.

Methods

Between January 2010 and June 2011, 85 patients (33 males, 52 females; mean age: 45 years) underwent immediate implant placement after extraction of single-rooted teeth. All implants were restored between 12 and 14 weeks after implant placement. The implant survival and its relationship with implant size and implantation site were evaluated by odds ratios (ORs).

Results

Implants were placed at the following sites: upper central incisor (UCI, n = 35), upper lateral incisor (ULI, n = 27), upper second premolar (U2ndP, n = 36), lower incisor (LI, n = 53), and lower premolar (LP, n = 22). Implants of the following sizes were used: 5 × 10 mm (n = 24), 5 × 8 mm (n = 21), 4.3 × 10 mm (n = 77), 4.3 × 8 mm (n = 36), 3.5 × 10 mm (n = 12), and 3.5 × 8 mm (n = 3). After a mean follow-up time of 47 months, the overall implant survival rate was 96%. Survival rate was highest at the LI site (98.1%) and lowest at the ULI site (92.6%). All of the 5-mm implants survived (100%), as did most of the 4.3 × 10 mm implants (96.1%). Implants of 4.3 × 8 mm and 3.5 × 10 mm were the least successful (91.7%). Mandibular implants had a better survival rate (97.3%) than maxillary implants (94.9%). There was no significant OR of increased survival for any particular implant size or site.

Conclusions

Immediate implant placement in fresh extraction sockets can give predictable clinical outcomes, regardless of the implant size and site of placement.     

CDIC纯钛人工牙种植体的研究与应用

CDIC人工牙种植体用纯钛金属材料加工制造而成，经严格的理化性能实验和生物实验性检测，各项指标符合国际相关标准。临床试用8年时间，提出了CDIC种植体的临床分类，建立了严格规范的手术操作程序和配套的种植义齿修复技术，为2714位病员植入了4116枚纯钛种植体。临床资料表明，CDIC种植体年使用量逐年增加，种植义具修复后使用效果良好。96年一季度的资料显示，种植体类型及品种增加，半埋置式锥状螺旋和柱状螺旋种植体各占12%和48%。分期组合式柱状螺旋种植体占25.4%，叶状种植体占4.4%，并对种植体植入手术方式和义齿修复方式进行了讨论与比较。结论说明建立CDIC人工牙种植体系列适合我国人体牙列缺损和缺失后不同颌骨解剖生理学的要求，可在临床推广应用。     

唑来膦酸系统治疗对骨质疏松时人工骨植骨愈合及种植体骨结合的影响

目的：研究唑来膦酸系统治疗对骨质疏松时人工骨植骨愈合及其内种植体骨结合的影响。方法：30只雌性SD大鼠随机分成3组：假手术组（A）、骨质疏松组（B）和唑来膦酸治疗组（C）。A组接受假手术,B、C组行双侧卵巢切除术。术后12周在大鼠右侧胫骨近中干骺端植入羟基磷灰石涂层种植体,并于种植体旁制备骨缺损,行Bio-oss骨粉同期植入术;C组给予唑来磷酸钠0.2mg/kg/3周肌注,A、B组注射生理盐水。种植术后第4周、12周分2批处死动物,标本制作不脱钙切片检测。结果：种植术后4周时,B组皮质骨厚度（TCB）、种植体骨结合率（IBCR）、新生骨量（NBV）、Bio-oss骨粉包被率（ERBP）均显著低于A组和C组（P〈0.01）;而C组除TCB外,其它参数则均显著高于A组（P〈0.01）。12周时,B组各项参数均显著低于A组和C组（P〈0.01）,C组除TCB略低于A组外（P〈0.05）,其它参数与A组相似（P〉0.05）。结论：实验性骨质疏松可延迟人工骨植骨愈合,降低种植体骨结合率;唑来膦酸系统应用则可拮抗骨质疏松的负面影响,促进植骨愈合,使种植体骨结合率增加。     

Histological evaluation of titanium fiber mesh-coated implants in a rabbit femoral condyle model

ObjectivesThis study was aimed to comparatively evaluate new bone formation into the pores of a flexible titanium fiber mesh (TFM) applied on the surface of implant.MethodsTwenty-eight custom made cylindrical titanium implants (4 ×10 mm) with and without a layer of two different types of TFM (fiber diameter of 22 µm and 50 µm, volumetric porosity ~70%) were manufactured and installed bilaterally in the femoral condyles of 14 rabbits. The elastic modulus for these two TFM types was ~20 GPa and ~5 GPa respectively, whereas the solid titanium was ~110 GPa. The implants (Control, TFM-22, TFM-50) were retrieved after 14 weeks of healing and prepared for histological assessment. The percentage of the bone area (BA%), the bone-to-implant contact (BIC%) and amount were determined.ResultsNewly formed bone into mesh porosity was observed for all three types of implants. Histomorphometric analyses revealed significantly higher (~2.5 fold) BA% values for TFM-22 implants (30.9 ± 9.5%) compared to Control implants (12.7 ± 6.0%), whereas BA% for TMF-50 did not significantly differ compared with Control implants. Furthermore, both TFM-22 and TFM-50 implants showed significantly higher BIC% values (64.9 ± 14.0%, ~2.5 fold; 47.1 ± 14.1%, ~2 fold) compared to Control (23.6 ± 17.4%). Finally, TFM-22 implants showed more and thicker trabeculae in the peri-implant region.SignificanceThis in vivo study demonstrated that implants with a flexible coating of TFM improve bone formation within the inter-fiber space and the peri-implant region.     

Rehabilitative Considerations for Dental Implants in the Diabetic Patient

Diabetes is a serious illness that affects many people, and there are many new cases diagnosed every year in all populations around the world. Dental implant is one of the restorative methods to replace missing teeth. As implants are directly anchored into bones, they provide stability, a more natural appearance, and minimize the risk of bone resorption. Thus, today, there is a high demand of dental implants and it is inevitable to meet diabetics who request implant treatment. However, Diabetes mellitus patients may pose contraindications to dental implants because of microvascular complications leading to slower healing process after surgery. Studies have shown that dental implantation failure rate in diabetic patients is much higher than that in non-diabetic patients. This article reviews the effect of diabetes on the osseointegration of implants and the soft tissue healing. It presents the factors used in assessing the severity of diabetes and its complications, as well as considerations for rehabilitation planning in these patients. In addition, the role of antibiotic prophylaxis has been reviewed since its effect on wound healing in diabetics is controversial. Integration of these factors by the dentist can dictate whether, as well as what type of implant supported prosthesis should be given to the diabetic patient.     

唑来膦酸局部治疗对骨质疏松时自体髂骨移植内种植体骨结合的影响

目的：研究唑来膦酸局部治疗对骨质疏松时自体髂骨移植内种植体骨结合的影响。方法：30只雌性家兔随机分成A、B、C 3组。B、C组行双侧卵巢切除术,A组接受假手术。术后12周测量股骨骨密度（BMD）。在家兔右侧胫骨近中干骺端制备骨缺损,行自体髂骨移植及同期种植体植入术,A、B组植入HA涂层种植体,C组植入唑来膦酸钠涂层种植体。术后第2、12周处死动物,制作硬组织切片,进行组织形态学观察及骨计量学检测。结果：A、B组BMD显著低于C组（P〈0.01）。术后2周,B、C组间TCBI、BCR、BVC相似,均显著低于A组（P〈0.01）。术后12周,A组TCB、IBCR、BVC最高,C组次之,B组最低（P〈0.01）。和2周比较,12周时TCB除B组略降低外（P〈0.05）,A组和C组变化均不明显;IBCR各组均显著增高（P〈0.01）;而BVC则是B组降低（P〈0.05）,A组和C组显著增高（P〈0.01）。结论：唑来膦酸局部应用则可拮抗骨质疏松的影响,使种植体骨结合率增加。     

Is zirconia a viable alternative to titanium for oral implant? A critical review

Purpose

Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation.

糖尿病兔与正常兔植入种植体骨整合对比研究

目的评价糖尿病兔与正常兔种植体植入后骨整合情况。方法建立糖尿病兔模型,在糖尿病兔及正常兔右侧胫骨内侧近中骨骺区植入钛种植体,于术后4、8、12周制作标本,摄胫骨正侧位片,扫描电镜观察,测定骨密度、种植体骨接触率等。结果与正常对照组相比,糖尿病组骨密度及种植体骨接触率均明显下降,12周骨接触率只能达到50%左右。结论糖尿病会降低种植体骨接触率,从而直接影响种植的成功率。     

Osteoporosis and Osseointegration of Implants

According to medical literature, osteoporosis and related bone pathologies are increasing in epidemic proportions. The exact etiology of the disease is unknown, but hormonal, dietary, and genetic factors all contribute to the related loss of bone density. In the disease process, bone loss occurs throughout the body. Research indicates that the mandible and maxilla are affected, and show oral manifestations. There is no scientific data to contraindicate the use of two-step osseointegrated implants in osteoporotic individuals. The purpose of this article is to review the literature regarding osteoporosis and its relationship to oral bone loss.     

The Effect of a Keratin Hydrogel Coating on Osseointegration: An Histological Comparison of Coated and Non-coated Dental Titanium Implants in an Ovine Model

Bioactive substances may be used to enhance the rate and quantity of bone healing during osseointegration of titanium dental implants. A pilot observational study was undertaken to assess a novel keratin hydrogel in six adult sheep utilising the femoral condyles as the surgical site to assess osseointegration. Implants and osteotomy sites were coated with the keratin gel prior to implant placement (test implants) whereas the opposite knee received unmodified control implants in each animal. Fifty 3.5 mm × 7 mm Neoss dental implants were surgically implanted with a range of 3–5 Neoss dental implants placed per surgical site in each knee and allowed to heal for 5 days or 2, 4, 8, 12 and 16 weeks prior to the sheep being sacrificed. Of the 50 placed implants, 24 were used for this study and analysed via resin-embedded, undemineralised sections from test and control implants to assess the range of healing around the unloaded dental implants. These dental implants were analysed using histomorphometric methods for the best 3 consecutive threads on each side and the percentage of bone to implant contact (%BIC) was used to determine the degree of osseointegration between test and control dental implants at each time point. All implants appeared osseointegrated at the time of sacrifice. One each of the pairs of control implants at 2, 4 and 12 weeks demonstrated minimal integration histologically, with %BIC <10 %. No test implants had %BIC <35 % at any time point. Mean %BIC for test implants was higher than controls at all time points except 5 days and 2 weeks. The range from 2 to 16 weeks healing was 39.7 % [SD 25.5 %] to 85.4 % [14.2 %] for test implants and 35.6 % [43.4 %] to 46.6 % [23.1 %] for controls. %BIC appeared to increase earlier in the test implants (from 4 weeks onwards) compared to controls. After 16 weeks, %BIC was almost twice as great in test implants as controls. This pilot observational study suggests that keratin hydrogel may promote earlier osseointegration around titanium dental implants. Further cross-sectional studies with larger sample sizes are warranted. The most marked difference between test and control implants was seen after 4 weeks. It is recommended that future studies in this model focus on healing after 4 weeks.     

拔牙后立即植入钛牙种植体的组织形态学研究

采用6只成年杂种狗，在拔除双侧下颌前臼齿和第一臼齿后，立即植入螺旋状和叶状钛牙种植体。分别在植入后1，2，3个月进行X线检查，组织学检查和扫描电镜观察。结果表明：拔牙后立即植入牙种植体，能与骨形成良好的骨性结合，螺旋状种植体周围骨愈合较快。作者认为拔牙后立即植入牙种植体只要手术设计合理，操作正确，仍是一种可行的方法。