Botticelli Daniele, Berglundh Tord, Buser Daniel, Lindhe Jan
Department of Periodontology, Faculty of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Clin Oral Implants Res. 2003 Feb;14(1):1-9. doi: 10.1034/j.1600-0501.2003.140101.x.
In a previous experiment, it was demonstrated that a wide marginal defect around an implant can heal with a high degree of osseointegration. The present experiment was performed to evaluate the degree and quality of de novo bone formation and osseointegration in marginal defects adjacent to submerged titanium implants. All mandibular premolars and 1st molars were extracted in four Labrador dogs. Four experimental sites were identified in the right side of the mandible. In two sites, custom-made implants with a sandblasted, large grit, acid-etched (SLA) surface were installed without further ostectomy (control sites). In the two remaining sites (test sites), a specially designed step drill was used to widen the marginal 5 mm of the canal. A barrier membrane was used to cover the implants in the defect sites. All implants were submerged. One month later, an identical procedure, including site preparation and implant installation, was performed in the left side of the mandible. Two months following the first implant installation procedure, biopsies were collected and prepared for sectioning. Ostectomy and implant installation in the control location resulted in a series of bone tissue alterations which eventually allowed newly formed bone to establish contact with the SLA surface. The marginal defect lateral to the implant in the test locations gradually became filled with newly formed bone. De novo bone formation started within the walls of the surgically prepared defect. Bone-to-implant contact was first established in the apical portion of the gap. This new bone tissue was in the coronal direction continuous with a dense, non-mineralized 'implant attached' soft tissue which, over time, also became mineralized to increase the height of the zone of bone-to-implant contact. The results suggest that healing of a wide marginal defect around an implant is characterized by appositional bone growth from the lateral and apical bone walls of the defect.
在先前的一项实验中,已证明种植体周围广泛的边缘性骨缺损能够实现高度的骨结合愈合。进行本实验是为了评估与潜入式钛种植体相邻的边缘性骨缺损中新生骨形成和骨结合的程度及质量。在四只拉布拉多犬中拔除了所有下颌前磨牙和第一磨牙。在下颌右侧确定了四个实验部位。在两个部位,安装了具有喷砂、大颗粒、酸蚀(SLA)表面的定制种植体,未进一步进行骨切除术(对照部位)。在其余两个部位(测试部位),使用专门设计的阶梯钻将根管边缘扩宽5毫米。使用屏障膜覆盖缺损部位的种植体。所有种植体均为潜入式。一个月后,在下颌左侧进行了相同的操作,包括部位准备和种植体植入。在首次种植体植入手术后两个月,采集活检组织并准备切片。对照部位的骨切除术和种植体植入导致了一系列骨组织改变,最终使新形成的骨与SLA表面建立接触。测试部位种植体外侧的边缘性骨缺损逐渐被新形成的骨填充。新生骨形成始于手术制备的缺损壁内。骨与种植体的接触首先在间隙的根尖部分建立。这种新的骨组织在冠状方向上与致密的、未矿化的“种植体附着”软组织连续,随着时间的推移,该软组织也会矿化,以增加骨与种植体接触区域的高度。结果表明,种植体周围广泛边缘性骨缺损的愈合特征是从缺损的外侧和根尖骨壁进行贴壁性骨生长。