Barak Shlomo, Neuman Moshe, Iezzi Giovanna, Piattelli Adriano, Perrotti Vittoria, Gabet Yankel
Private Practice, Tel Aviv, Israel.
Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy.
Clin Oral Implants Res. 2016 Aug;27(8):935-42. doi: 10.1111/clr.12661. Epub 2015 Aug 6.
In the present study, a new healing cap that could generate a pulsed electromagnetic field (PEMF) around titanium implants to stimulate peri-implant osteogenesis was tested in the rabbit model.
A total of 22 implants were inserted in the proximal tibial metaphysis of 22 rabbits. A healing cap containing the active device was inserted in half of the implants (11 test implants); an "empty" healing cap was inserted in the other ones (11 control implants). The animals were euthanized after 2 and 4 weeks, and the samples were processed for micro-computed tomography and histology. The peri-implant volume was divided into coronal (where the PEMF was the strongest) and apical regions.
Most of the effects of the tested device were confined to the coronal region. Two weeks post-implantation, test implants showed a significant 56% higher trabecular bone fraction (BV/TV), associated with enhanced trabecular number (Tb.N, +37%) and connectivity density (Conn.D, +73%) as compared to the control group; at 4 weeks, the PEMF induced a 69% increase in BV/TV and 34% increase of Tb.N. There was no difference in the trabecular thickness (Tb.Th) at either time point. Furthermore, we observed a 48% higher bone-to-implant contact (BIC) in the test implants vs. controls after 2 weeks; this increase tended to remain stable until the fourth week. Mature trabecular and woven bone were observed in direct contact with the implant surface with no gaps or connective tissue at the bone-implant interface.
These results indicate that the PEMF device stimulated early bone formation around dental implants resulting in higher peri-implant BIC and bone mass already after 2 weeks which suggests an acceleration of the osseointegration process by more than three times.
在本研究中,在兔模型中测试了一种新型愈合帽,该愈合帽可在钛植入物周围产生脉冲电磁场(PEMF)以刺激种植体周围骨生成。
将总共22枚植入物植入22只兔的胫骨近端干骺端。在一半的植入物(11枚测试植入物)中插入含有有源装置的愈合帽;在另一半植入物(11枚对照植入物)中插入“空”愈合帽。在2周和4周后对动物实施安乐死,并对样本进行显微计算机断层扫描和组织学处理。将种植体周围体积分为冠状区域(PEMF最强的区域)和根尖区域。
测试装置的大部分效果局限于冠状区域。植入后2周,与对照组相比,测试植入物的小梁骨分数(BV/TV)显著高出56%,小梁数量(Tb.N,增加37%)和连接密度(Conn.D,增加73%)也有所增加;在4周时,PEMF使BV/TV增加69%,Tb.N增加34%。在两个时间点的小梁厚度(Tb.Th)均无差异。此外,我们观察到2周后测试植入物的骨与种植体接触率(BIC)比对照组高48%;这种增加在第4周前趋于保持稳定。观察到成熟的小梁骨和编织骨与种植体表面直接接触,在骨 - 种植体界面处没有间隙或结缔组织。
这些结果表明,PEMF装置刺激了牙种植体周围的早期骨形成,在2周后就导致种植体周围更高的BIC和骨量,这表明骨整合过程加速了三倍以上。