具有多孔表面的SLM多根牙种植体的实验研究

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (5): 397-403.

具有多孔表面的SLM多根牙种植体的实验研究

张青¹, 区跃坚¹, 游嘉², 许海燕¹, 孙启俊¹

1.浙江省湖州市中心医院/浙江大学湖州医院口腔科,浙江湖州 313000;
2.浙江工业大学特种装备制造与先进加工技术教育部/浙江省重点实验室,浙江杭州 310032

收稿日期:2016-06-15 出版日期:2016-09-20 发布日期:2016-10-14
通讯作者: 区跃坚,E-mail：yuejianou@sina.com
作者简介:张青（1981-）,女,学士,主治医师,E-mail：buliny@163.com
基金资助:
国家自然科学基金(51375453); 浙江省公益技术研究社会发展项目 (2014C33136); 浙江省卫生一般研究计划(2014KYA204)

Osseointegration study of SLM porous multi-rooted implants in rabbits

ZHANG Qing¹, OU Yue-jian¹, YOU Jia², XU Hai-yan¹, SUN Qi-jun¹

1.Department of Stomatology, Huzhou Central Hospital, Huzhou Hospital of Zhejiang University. Huzhou 313000;
2. Key Laboratory of E&M, Ministry of Education&Zhejiang Province, Zhejiang University of Technology. Hangzhou 310032, Zhejiang Province, China

Received:2016-06-15 Online:2016-09-20 Published:2016-10-14

摘要/Abstract

摘要： 目的: 设计并制造一种表面具有多孔连通结构的多根牙种植体 (MRI) ,并评价其骨结合能力。方法: 以选择性激光熔化(SLM)技术制造的多根牙种植体(MRI)作为实验组,用市售可吸收介质喷砂表面处理(RBM)的种植体作为对照组,分别植入到新西兰大白兔的双侧胫骨近心端和股骨的远心端。12周后通过显微CT扫描、硬组织切片、推出实验和抗扭转实验评价骨结合情况。采用SPSS 19.0 软件包对数据进行分析。结果: 通过显微CT测量发现,MRI组的骨体积密度始终高于RBM组,并且MRI组的骨体积密度最后达到 48.41%的峰值。组织学分析显示,MRI组的周围骨结合优于RBM组。硬组织切片显示,4周时新生骨组织开始长入种植体表面孔隙结构中,8周时新生骨组织长入双根分叉区域内。生物力学测试显示,MRI组的推出力从 294.7 N 增加到 446.5 N,平均最大扭力从 81.2 N 提高到 289.6 N;而RBM组的平均最大扭力仅从34.8 N提高到 87.8 N。结论: SLM技术制造的具有多孔连通表面结构的MRI,组织学和生物力学性能评估表明其具有良好的骨结合性能,可改善种植体的成骨性能。

关键词: 种植体设计, 生物力学, 选择性激光熔化, 多根牙种植体, 骨结合

Abstract: PURPOSE: The aim of this study was to develop a multi-rooted dental implant (MRI) with a connected porous surface structure to facilitate osseointegration. METHODS: MRIs manufactured by selective laser melting (SLM) and commercial implants with resorbable blasting media (RBM)-treated surfaces were inserted into the hind limbs of New Zealand white rabbits. Osseointegration was evaluated periodically over 12 weeks by micro-computerized tomography (CT) scanning, histological analysis, mechanical push-out tests, and torsion tests. The results were analyzed by using SPSS19.0 software package for ANOVA intra-group and un-paired t test. RESULTS: Bone volume densities were consistently higher in MRI group than in RBM group throughout the study period, ultimately resulting in a peak value of 48.41% for MRI. Histological analysis revealed denser surrounding bone growth in MRIs; after 4 and 8 weeks, bone tissue had grown into the pore structures and root bifurcation areas, respectively. Biomechanics tests indicated binding of the porous MRIs to the neobone tissues, as push-out forces strengthened from 294.7 N to 446.5 N and maximum mean torsion forces improved from 81.2 N to 289.6 N(MRI), versus 34.8 N to 87.8 N in the RBM group. CONCLUSIONS: MRIs manufactured by SLM possess a connected porous surface structure that improves the osteogenic characteristics of the implant surface and may promote implant survival.

Key words: Implant design, Biomechanics, Selective laser melting, Multi-rooted implant, Osseointegration

中图分类号:

R782.1

张青, 区跃坚, 游嘉, 许海燕, 孙启俊. 具有多孔表面的SLM多根牙种植体的实验研究[J]. 中国口腔颌面外科杂志, 2016, 14(5): 397-403.

ZHANG Qing, OU Yue-jian, YOU Jia, XU Hai-yan, SUN Qi-jun. Osseointegration study of SLM porous multi-rooted implants in rabbits[J]. China J Oral Maxillofac Surg, 2016, 14(5): 397-403.

参考文献

[1] Chappuis V, Buser R, Brägger U, et al. Long-term outcomes of dental implants with a titanium plasma-sprayed surface: a 20-year prospective case series study in partially edentulous patients [J]. Clin Implant Dent Relat Res, 2013, 15(6): 780-790.
[2] Papaspyridakos P, Chen CJ, Singh M, et al. Success criteria in implant dentistry: a systematic review[J]. J Dent Res, 2012, 91(3): 242-248.
[3] Fugazzotto PA, Vlassis J. Long-term success of sinus augmentation using various surgical approaches and grafting materials [J]. Int J Oral Maxillofac Implants, 1998, 13(1): 52-58.
[4] Sisti A, Canullo L, Mottola MP, et al. Clinical evaluation of a ridge augmentation procedure for the severely resorbed alveolar socket: multicenter randomized controlled trial, preliminary results [J]. Clin Oral Implants Res, 2012, 23(5): 526-535.
[5] Jackson BJ. Small diameter implants: specific indications and considerations for the posterior mandible: a case report [J]. J Oral Implantol, 2011, 37: 156-164.
[6] Balshi TJ, Wolfinger GJ. Two-implant-supported single molar replacement: interdental space requirements and comparison to alternative options [J]. Int J Periodontics Restorative Dent, 1997, 17(5): 426-435.
[7] Mazor Z, Lorean A, Mijiritsky E, et al. Replacement of a molar with 2 narrow diameter dental implants[J]. Implant Dent, 2012, 21(1): 36-38.
[8] Sohn DS, Bae MS, Heo JU, et al. Retrospective multicenter analysis of immediate provisionalization using one-piece narrow-diameter (3.0-mm) implants [J]. Int J Oral Maxillofac Implants, 2011, 26(1): 163-168.
[9] Desai SR, Karthikeyan I, Singh R. Evaluation of micromovements and stresses around single wide-diameter and double implants for replacing mandibular molar: a three-dimensional FEA[J]. ISRN Dent, 2012, 2012: 680587.
[10] Koike M, Martinez K, Guo L, et al. Evaluation of titanium alloy fabricated using electron beam melting system for dental applications[J]. J Mater Process Technol, 2011, 211(8): 1400-1408.
[11] Traini T, Mangano C, Sammons RL, et al. Direct laser metal sintering as a new approach to fabrication of an isoelastic functionally graded material for manufacture of porous titanium dental implants [J]. Dent Mater, 2008, 24(11): 1525-1533.
[12] Chahine G, Koike M, Okabe T, et al. The design and production of Ti-6Al-4V ELI customized dental implants [J]. JOM, 2008, 60(11): 50-55.
[13] Moin DA, Hassan B, Mercelis P, et al. Designing a novel dental root analogue implant using cone beam computed tomography and CAD/CAM technology [J]. Clin Oral Implants Res, 2013, 24(Suppl A100): 25-27.
[14] Mangano FG, De Franco M, Caprioglio A, et al. Immediate, non-submerged, root-analogue direct laser metal sintering (DLMS) implants: a 1-year prospective study on 15 patients [J]. Lasers Med Sci, 2014, 29(4): 1321-1328.
[15] Karageorgiou V, Kaplan D. Porosity of 3D biomaterial scaffolds and osteogenesis[J]. Biomaterials, 2005, 26(27): 5474-5491.
[16] Ryan G, Pandit A, Apatsidis DP. Fabrication methods of porous metals for use in orthopaedic applications [J]. Biomaterials, 2006, 27(13): 2651-2670.
[17] Gotz HE, Muller M, Emmel A, et al. Effect of surface finish on the osseointegration of laser-treated titanium alloy implants [J]. Biomaterials, 2004, 25(18): 4057-4064.
[18] Xue W, Krishna BV, Bandyopadhyay A, et al. Processing and biocompatibility evaluation of laser processed porous titanium [J]. Acta Biomater, 2007, 3(6): 1007-1018.
[19] Biemond JE, Hannink G, Verdonschot N, et al. Bone ingrowth potential of electron beam and selective laser melting produced trabecular-like implant surfaces with and without a biomimetic coating [J]. J Mater Sci Mater Med, 2013, 24(3): 745-753.
[20] Van Bael S, Chai YC, Truscello S, et al. The effect of pore geometry on the in vitro biological behavior of human periosteum-derived cells seeded on selective laser-melted Ti6Al4V bone scaffolds [J]. Acta Biomater, 2012, 8(7): 2824-2834.
[21] 游嘉, 方利华, 张青, 等. 基于SLM技术的表面多孔钛金属多根牙种植体的骨结合研究 [J].中国生物医学工程学报, 2015, 34(3): 315-322.
[22] Guo XE. Mechanical properties of cortical bone and cancellous bone tissue [C]// Cowin SC. Bone mechanics handbook[M]. Boca Raton: CRC Press, 2001: 1-23.
[23] Grunder U, Gracis S, Capelli M. Influence of the 3-D bone-to-implant relationship on esthetics [J]. Int J Periodontics Restorative Dent, 2005, 25(2): 113-119.
[24] Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest [J]. J Periodontol, 2000, 71(4): 546-549.