Chappuis Vivianne, Cavusoglu Yeliz, Gruber Reinhard, Kuchler Ulrike, Buser Daniel, Bosshardt Dieter D
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Laboratory of Oral Cell Biology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Clin Implant Dent Relat Res. 2016 Aug;18(4):686-98. doi: 10.1111/cid.12375. Epub 2015 Sep 17.
Current strategies to reduce medical device-associated infections propose zirconia as a potential implant material which may limit bacterial adhesion. Because multinucleated giant cells (MNGCs) have been detected on these implant surfaces, concerns have been raised regarding tissue integration.
The present study examined the presence of MNGCs and their subsequent effect upon tissue integration. Surface-modified implants made of yttria-stabilized (TZP) and alumina-toughened zirconia (ATZ) were compared with commercially pure titanium (Ti).
Seven miniature pigs received three implants on either side of the maxilla. After healing periods of 4 and 8 weeks, the tissue response at the implant surfaces was characterized according to three specific parameters: bone-to-implant contact (BIC), MNGC-to-implant contact (MIC), and the peri-implant bone density (BD).
Despite being present on all tested implant surfaces, MNGCs were not associated with an inflammatory cell infiltrate or with fibrous encapsulation. MNGCs were less numerous on the Ti implants (range: 3.9-5.2%) compared with the ceramic implants (range: 17.6-30.3%, p < .0001). Even though the values of newly formed bone and pristine bone in direct contact with the implant surfaces were high at 4 weeks (tBIC: Ti = 82.3%, TZP = 64.3%, ATZ = 70%), a negative correlation was observed between the presence of MNGCs and newly formed bone at the implant surface (p < .001). Interestingly, the newly formed peri-implant bone density, defined as the percentage of new bone area inside the screw threads (nBD), was not diminished by the presence of MNGCs.
Differences in the presence of MNGCs and the BIC parameters between Ti and the ceramic implants appear to be a local cellular phenomenon which is restricted to the implant-bone marrow interface and do not affect the peri-implant bone formation. Factors triggering MNGC differentiation and their persistence in response to biomaterial surface need to be investigated in future studies.
当前减少医疗器械相关感染的策略提出，氧化锆作为一种潜在的植入材料，可能会限制细菌粘附。由于在这些植入物表面检测到多核巨细胞（MNGC），人们对组织整合产生了担忧。
本研究检测了MNGC的存在及其对组织整合的后续影响。将氧化钇稳定的（TZP）和氧化铝增韧氧化锆（ATZ）制成的表面改性植入物与商业纯钛（Ti）进行比较。
7只小型猪在上颌两侧各植入3个植入物。在4周和8周的愈合期后，根据三个特定参数对植入物表面的组织反应进行表征：骨与植入物接触（BIC）、MNGC与植入物接触（MIC）以及植入物周围骨密度（BD）。
尽管在所有测试的植入物表面都存在MNGC，但MNGC与炎性细胞浸润或纤维包裹无关。与陶瓷植入物（范围：17.6 - 30.3%，p <.0001）相比，Ti植入物上的MNGC数量较少（范围：3.9 - 5.2%）。尽管在4周时与植入物表面直接接触的新形成骨和原始骨的值很高（tBIC：Ti = 82.3%，TZP = 64.3%，ATZ = 70%），但在植入物表面观察到MNGC的存在与新形成骨之间呈负相关（p <.001）。有趣的是，定义为螺纹内新骨面积百分比的新形成植入物周围骨密度（nBD）并未因MNGC的存在而降低。
Ti与陶瓷植入物之间MNGC存在情况和BIC参数的差异似乎是一种局部细胞现象，仅限于植入物 - 骨髓界面，并不影响植入物周围骨形成。未来的研究需要调查触发MNGC分化及其对生物材料表面反应持续存在的因素。
Zotero 插件