Letić-Gavrilović A, Scandurra R, Abe K
Department of Biochemistry, Faculty of Stomatology, University of Beograd, Beograd, Yugoslavia.
Dent Mater J. 2000 Jun;19(2):99-132. doi: 10.4012/dmj.19.99.
The purpose of this review is to summarise recent advances in the design and composition of bioactive surface layers of implantabile biomaterials, and thus the genetic potential of osteoprogenitor cells to recognize and respond to these diverse implanted biomaterials. Changes applied to a biomaterial's surface, in general, could improve its biocompatibility, osseointegration and durability properties, which are required for long-term implantation in the living body. In this review, the implant-bone interface was evaluated and interpreted on the basis of osteoblast cell cultures, i.e., on the genetic potential of osteoblasts to express different phenotype markers depending on the type of biomaterials used. The interface formed by in vitro-grown osteoblasts may be used to identify components of the in vivo implant-bone interface. Over the years, a large number of implant systems consisting of many different biomaterials have been introduced in dentistry and orthopaedics. This paper discusses the performance of currently used metals and other biomaterials, by focusing on the events which occur immediately after implantation and on their impact on the bone-implant interface. The review demonstrates that continuous improvements in composition, surface modality and design of implants may benefit osseointegration and clinical longevity of such implants. No load-bearing conditions or clinical status are discussed. Titanium (Ti) and calcium phosphate ceramics are regarded as the most biocompatible synthetic substances known to be used in hard tissue implantation. These biomaterials are osteoconductive, and do not induce ectopic bone formation. Nonetheless, they provide a physical matrix which is suitable for the deposition of new bone and may guide both the growth and extension of the bone. Comparative investigation evaluated that Ti implant systems appear to be apposed by more bone than ceramic systems, although alternatives concerning the type of Ti alloy and bioactive surface layer engineering, generate extremely diverse osseointegration results. Manufacturers have created an extensive range of inorganic or ceramic coatings on Ti implants in order to achieve better bone healing and osteoconduction. Biologically active molecules, added to the implant surface, represent breakthroughs in guided interfacial osteogenesis. This methodology offers an enormous potential of genetic controlling and promoting osteogenesis. The bone growth factors are not fully understood, but most researchers agree that the contact between the bioactive surface layer of the implant and bone is not static but dynamic and that the above factors may maximise the implant osseointegration.
本综述的目的是总结可植入生物材料生物活性表面层在设计和组成方面的最新进展，以及骨祖细胞识别和响应这些不同植入生物材料的遗传潜力。一般来说，对生物材料表面进行的改变可以改善其生物相容性、骨整合和耐久性，这些都是在活体中长期植入所必需的特性。在本综述中，基于成骨细胞培养，即根据所用生物材料的类型，成骨细胞表达不同表型标志物的遗传潜力，对植入物与骨的界面进行了评估和解释。体外培养的成骨细胞形成的界面可用于识别体内植入物与骨界面的组成部分。多年来，牙科和骨科领域引入了大量由许多不同生物材料组成的植入系统。本文通过关注植入后立即发生的事件及其对骨 - 植入物界面的影响，讨论了目前使用的金属和其他生物材料的性能。该综述表明，植入物在组成、表面形态和设计方面的持续改进可能有益于此类植入物的骨整合和临床使用寿命。本文未讨论负重条件或临床状况。钛（Ti）和磷酸钙陶瓷被认为是用于硬组织植入的已知生物相容性最佳的合成物质。这些生物材料具有骨传导性，不会诱导异位骨形成。尽管如此，它们提供了一个适合新骨沉积的物理基质，并且可以引导骨的生长和延伸。比较研究评估发现，Ti植入系统似乎比陶瓷系统能附着更多的骨，尽管关于Ti合金类型和生物活性表面层工程的选择会产生极其多样的骨整合结果。制造商在Ti植入物上制造了广泛的无机或陶瓷涂层，以实现更好的骨愈合和骨传导。添加到植入物表面的生物活性分子代表了引导界面骨生成的突破。这种方法具有巨大的遗传控制和促进骨生成的潜力。骨生长因子尚未完全被了解，但大多数研究人员一致认为，植入物的生物活性表面层与骨之间的接触不是静态的，而是动态的，并且上述因素可能会使植入物的骨整合最大化。
