Shibli Jamil Awad, Marcantonio Elcio, d'Avila Susana, Guastaldi Antonio Carlos, Marcantonio Elcio
Dental Research Division, Department of Periodontology, Guarulhos University, Praça Tereza Cristina 01, 07023-070 Guarulhos, São Paulo, Brazil.
J Periodontol. 2005 Jul;76(7):1092-9. doi: 10.1902/jop.2005.76.7.1092.
The failure of osseointegration in oral rehabilitation has gained importance in current literature and in clinical practice. The integration of titanium dental implants in alveolar bone has been partly ascribed to the biocompatibility of the implant surface oxide layer. The aim of this investigation was to analyze the surface topography and composition of failed titanium dental implants in order to determine possible causes of failure.
Twenty-one commercially pure titanium (cpTi) implants were retrieved from 16 patients (mean age of 50.33 +/- 11.81 years). Fourteen implants were retrieved before loading (early failures), six after loading (late failures), and one because of mandibular canal damage. The failure criterion was lack of osseointegration characterized as dental implant mobility. Two unused implants were used as a control group. All implant surfaces were examined by scanning electron microscopy (SEM) and energy-dispersive spectrometer x-ray (EDS) to element analysis. Evaluations were performed on several locations of the same implant.
SEM showed that the surface of all retrieved implants consisted of different degrees of organic residues, appearing mainly as dark stains. The surface topography presented as grooves and ridges along the machined surface similar to control group. Overall, foreign elements such as carbon, oxygen, sodium, calcium, silicon, and aluminum were detected in failed implants. The implants from control group presented no macroscopic contamination and clear signs of titanium.
These preliminary results do not suggest any material-related cause for implant failures, although different element composition was assessed between failed implants and control implants.
口腔修复中骨结合失败在当前文献和临床实践中已变得愈发重要。钛牙种植体在牙槽骨中的结合部分归因于种植体表面氧化层的生物相容性。本研究的目的是分析失败的钛牙种植体的表面形貌和成分，以确定可能的失败原因。
从16例患者（平均年龄50.33±11.81岁）中取出21枚商业纯钛（cpTi）种植体。14枚种植体在加载前取出（早期失败），6枚在加载后取出（晚期失败），1枚因下颌管损伤取出。失败标准为缺乏以牙种植体松动为特征的骨结合。将2枚未使用的种植体用作对照组。通过扫描电子显微镜（SEM）和能量色散光谱X射线（EDS）对所有种植体表面进行元素分析检查。在同一枚种植体的多个位置进行评估。
SEM显示，所有取出的种植体表面均有不同程度的有机残留物，主要表现为深色污渍。表面形貌呈现出与对照组类似的沿加工表面的沟槽和脊状。总体而言，在失败的种植体中检测到碳、氧、钠、钙、硅和铝等外来元素。对照组的种植体没有宏观污染且有明显的钛迹象。
尽管在失败的种植体和对照种植体之间评估了不同的元素组成，但这些初步结果并未表明种植体失败存在任何与材料相关的原因。
