Coelho Paulo G, Granjeiro José M, Romanos George E, Suzuki Marcelo, Silva Nelson R F, Cardaropoli Giuseppe, Thompson Van P, Lemons Jack E
Department of Biomaterials and Biomimetics, New York University, New York, New York 10010, USA.
J Biomed Mater Res B Appl Biomater. 2009 Feb;88(2):579-96. doi: 10.1002/jbm.b.31264.
Among dental implant design alterations, surface modifications have been by far the most investigated topic. Regarding implant surface research, the lack of hierarchical approaches relating in vitro, in vivo, clinical trials, and ex vivo analyses has hindered biomaterials scientists with clear informed rationale guidelines for implant surface design. This manuscript provides a critical hierarchical overview of the in vitro, laboratory in vivo, clinical, and ex vivo methodologies used to investigate the performance of novel biomaterials aiming to allow dental professionals to better evaluate the past, present, and future dental implant surface research. This manuscript also contains an overview of the commercially available surface texture and chemistry modifications including novel nanotechnology-based fabrication processes. Over the last decade, surface texturing has been the most utilized parameter for increasing the host-to-implant response. Recently, dental implant surfaces utilizing reduced length scale physico/chemical features (atomic and nanometric) have shown the potential to synergistically use both texture and the inclusion of bioactive ceramic components on the surface. Although surface modifications have been shown to enhance osseointegration at early implantation times, information concerning its long-term benefit to peri-implant tissues is lacking due to the reduced number of controlled clinical trials. Given the various implants/surfaces under study, the clinician should ask, founded on the basic hierarchical approach described for the in vitro, laboratory in vivo data, as well as the results of clinical studies to effectiveness before use of any dental implant.
在牙种植体设计变更中，表面改性是迄今为止研究最多的课题。关于种植体表面研究，缺乏将体外、体内、临床试验和离体分析联系起来的分层方法，这阻碍了生物材料科学家获得用于种植体表面设计的清晰明智的理论指导方针。本手稿对用于研究新型生物材料性能的体外、体内实验室、临床和离体方法进行了批判性的分层概述，旨在让牙科专业人员更好地评估过去、现在和未来的牙种植体表面研究。本手稿还概述了市售的表面纹理和化学改性，包括基于新型纳米技术的制造工艺。在过去十年中，表面纹理化一直是用于增强宿主对种植体反应的最常用参数。最近，利用减小长度尺度的物理/化学特征（原子和纳米级）的牙种植体表面已显示出协同利用纹理和在表面包含生物活性陶瓷成分的潜力。尽管表面改性已被证明在植入早期可增强骨整合，但由于对照临床试验数量减少，缺乏关于其对种植体周围组织长期益处的信息。鉴于正在研究的各种种植体/表面，临床医生应根据针对体外、体内实验室数据以及临床研究结果所描述的基本分层方法，在使用任何牙种植体之前询问其有效性。
