临界尺寸的牙槽嵴顶种植体周围缺损模型:特征与应用

The critical-size supraalveolar peri-implant defect model: characteristics and use.

作者信息

Wikesjö Ulf M E, Susin Cristiano, Qahash Mohammed, Polimeni Giuseppe, Leknes Knut N, Shanaman Richard H, Prasad Hari S, Rohrer Michael D, Hall Jan

机构信息

Laboratory for Applied Periodontal & Craniofacial Regeneration, Medical College of Georgia School of Dentistry - Periodontics/Oral Biology & Maxillofacial Pathology, Augusta, GA 30912, USA.

出版信息

J Clin Periodontol. 2006 Nov;33(11):846-54. doi: 10.1111/j.1600-051X.2006.00985.x. Epub 2006 Sep 11.

Abstract

OBJECTIVE

Novel implant technologies and reconstructive therapies for alveolar augmentation require pre-clinical evaluation to estimate their biologic potential, efficacy, and safety before clinical application. The objective of this report is to present characteristics and use of the critical-size, supraalveolar, peri-implant defect model.

METHODS

Bilateral extraction of the mandibular premolars was performed in 12 Hound Labrador mongrel dogs following horizontal surgical cut-down of the alveolar ridge approximating 6 mm. Each jaw quadrant received three custom-produced TiUnite, phi 4.0 x 10 mm threaded implants placed into osteotomies prepared into the extraction sites of the third and fourth premolars. The implants exhibited a reference notch 5 mm from the implant platform to facilitate surgical placement leaving 5 mm of the implant in a supraalveolar position, and to serve as a reference point in the radiographic, histologic and histometric analysis. The implants were submerged under the mucoperiosteal flaps for primary intention healing. Fluorescent bone markers were administered at weeks 3 and 4 post-surgery, and pre-euthanasia. The animals were euthanized following an 8-week healing interval when block biopsies were collected for analysis.

RESULTS

Healing was generally uneventful. The radiographic and histometric evaluations demonstrate the limited osteogenic potential of this defect model. Whereas lingual peri-implant sites exhibited a mean (+/-SE) bone gain of 0.4+/-0.1 mm, resorption of the buccal crestal plate resulted in a mean bone loss of 0.4+/-0.2 mm for an overall osteogenic potential following sham-surgery averaging 0.0+/-0.1 mm. Overall bone density and bone-implant contact in the contiguous resident bone averaged 79.1+/-1.1% and 76.9+/-2.3%, respectively.

CONCLUSION

The results suggest that the critical-size, supraalveolar, peri-implant defect model appears a rigorous tool in the evaluation of candidate technologies for alveolar reconstruction and osseointegration of endosseous oral implants. Limited innate osteogenic potential allows critical evaluation of osteogenic, osteoconductive, or osteoinductive technologies in a challenging clinical setting.

摘要

目的

新型牙槽嵴增高植入技术和重建疗法在临床应用前需要进行临床前评估,以估计其生物学潜力、疗效和安全性。本报告的目的是介绍临界尺寸、牙槽嵴上方、种植体周围缺损模型的特点及应用。

方法

对12只杂种猎兔犬进行双侧下颌前磨牙拔除术,沿牙槽嵴水平切开约6mm。每个颌骨象限在第三和第四前磨牙拔牙位点制备的骨切口中植入3颗定制的TiUnite φ4.0×10mm螺纹种植体。种植体在距种植体平台5mm处有一个参考凹槽,便于手术植入,使种植体5mm处于牙槽嵴上方位置,并作为影像学、组织学和组织计量学分析的参考点。种植体被埋置于粘骨膜瓣下进行一期愈合。在术后第3周、第4周和安乐死前夕给予荧光骨标记物。8周愈合期后对动物实施安乐死,并采集块状活检组织进行分析。

结果

愈合过程总体顺利。影像学和组织计量学评估显示该缺损模型的成骨潜力有限。舌侧种植体周围位点平均(±标准误)骨增量为0.4±0.1mm,而颊侧嵴顶骨板吸收导致平均骨丢失0.4±0.2mm,假手术组的总体成骨潜力平均为0.0±0.1mm。相邻存留骨的总体骨密度和骨-种植体接触率分别平均为79.1±1.1%和76.9±2.3%。

结论

结果表明,临界尺寸、牙槽嵴上方、种植体周围缺损模型似乎是评估牙槽嵴重建候选技术和骨内口腔种植体骨整合的严格工具。有限的固有成骨潜力有助于在具有挑战性的临床环境中对成骨、骨传导或骨诱导技术进行严格评估。

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