两颗在14年加载期后取出的人羟基磷灰石涂层牙种植体：一份组织学和组织形态计量学病例报告。

Two human hydroxyapatite-coated dental implants retrieved after a 14-year loading period: a histologic and histomorphometric case report.

作者信息

Iezzi Giovanna, Scarano Antonio, Petrone Giovanna, Piattelli Adriano

机构信息

Dental School, University of Chieti-Pescara, Chieti, Italy.

出版信息

J Periodontol. 2007 May;78(5):940-7. doi: 10.1902/jop.2007.060271.

DOI:10.1902/jop.2007.060271

PMID:17470030

Abstract

BACKGROUND

Controversy over the long-term clinical effectiveness of hydroxyapatite (HA)-coated dental implants still persists, despite numerous clinical studies documenting high survival rates. Concerns about the degradation of the coating over the years have been raised; it has been speculated that resorption of the HA could produce a space between the implant and the bone with a resultant mechanical instability.

METHODS

Two HA-coated implants were retrieved due to a fracture of the abutment screws after a loading period of 14 years and were treated to obtain thin ground sections for histologic evaluation.

RESULTS

At low-power magnification, it was possible to observe that the HA coating was in contact with mature bone. No gaps or connective fibrous tissue was found at the implant-bone interface. No epithelial downgrowth was present. No acute or chronic inflammatory cell infiltrate was present at the implant-bone interface. No foreign body reaction was present in the peri-implant tissues. Some osteocytes were in direct contact with the coating. For implant 1, the percentage of bone-titanium contact was 25% +/- 2.1%, and the percentage of bone-HA contact was 35% +/- 1.4%. The total bone-implant contact was approximately 60%. The HA coating appeared to be resorbed in 46% +/- 3.2% of the implant perimeter, especially in the coronal portions of the implant. For implant 2, the mean percentage of bone-HA contact was 13% +/- 1.8%, and the mean percentage of bone-titanium contact was 15% +/- 2.3%. The total bone-implant contact was approximately 28%. The HA coating appeared to be resorbed for a mean of 68% +/- 4.1% of the implant perimeter, especially in the coronal portion of the implant.

CONCLUSIONS

No acute or chronic inflammatory cell infiltrate was present in the peri-implant tissues. No signs of coating infection, fatigue, or failure were observed in two specimens. The HA coating may not be susceptible to degradation or dissolution under long-term function.

摘要

背景

尽管众多临床研究记录了高生存率，但羟基磷灰石（HA）涂层牙种植体的长期临床有效性仍存在争议。多年来，人们对涂层的降解提出了担忧；据推测，HA的吸收可能会在种植体与骨之间产生间隙，从而导致机械不稳定。

方法

在加载14年后，由于基台螺钉骨折，取出两枚HA涂层种植体，并进行处理以获得用于组织学评估的薄磨片。

结果

在低倍放大下，可以观察到HA涂层与成熟骨接触。在种植体-骨界面未发现间隙或结缔组织纤维。没有上皮向下生长。在种植体-骨界面没有急性或慢性炎性细胞浸润。种植体周围组织中没有异物反应。一些骨细胞与涂层直接接触。对于种植体1，骨与钛的接触百分比为25%±2.1%，骨与HA的接触百分比为35%±1.4%。骨与种植体的总接触约为60%。HA涂层似乎在种植体周长的46%±3.2%被吸收，尤其是在种植体的冠部。对于种植体2，骨与HA的平均接触百分比为13%±1.8%，骨与钛的平均接触百分比为15%±2.3%。骨与种植体的总接触约为28%。HA涂层似乎平均在种植体周长的68%±4.1%被吸收，尤其是在种植体的冠部。