Zimmer Biomet, Palm Beach Gardens, FL, USA.
School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
Clin Oral Implants Res. 2018 Feb;29(2):164-174. doi: 10.1111/clr.13074. Epub 2017 Oct 2.
This study evaluated new bone formation activities and trabecular bone microarchitecture within the highly porous region of Trabecular Metal™ Dental Implants (TM) and between the threads of Tapered Screw-Vent® Dental Implants (TSV) in fresh canine extraction sockets.
Eight partially edentulated dogs received four implants (4.1 mmD × 13 mmL) bilaterally in mandibular fresh extraction sockets (32 TM, 32 TSV implants), and allowed to heal for 2, 4, 8, and 12 weeks. Calcein was administered to label mineralizing bone at 11 and 4 days before euthanasia for dogs undergoing all four healing periods. Biopsies taken at each time interval were examined histologically. Histomorphometric assay was conducted for 64 unstained and 64 stained slides at the region of interest (ROI) (6 mm long × 0.35 mm deep) in the midsections of the implants. Topographical and chemical analyses were also performed.
Histomorphometry revealed significantly more new bone in the TM than in the TSV implants at each healing time (p = .0014, .0084, .0218, and .0251). Calcein-labeled data showed more newly mineralized bone in the TM group than in the TSV group at 2, 8, and 12 weeks (p = .045, .028, .002, respectively) but not at 4 weeks (p = .081). Histologically TM implants exhibited more bone growth and dominant new immature woven bone at an earlier time point than TSV implants. The parameters representing trabecular bone microarchitecture corroborated faster new bone formation in the TM implants when compared to the TSV implants. TM exhibited an irregular faceted topography compared to a relatively uniform microtextured surface for TSV. Chemical analysis showed peaks associated with each implant's composition material, and TSV also showed peaks reflecting the elements of the calcium phosphate blasting media.
Results suggest that the healing pathway associated with the highly porous midsection of TM dental implant could enable faster and stronger secondary implant stability than conventional osseointegration alone; however, prospective clinical studies are needed to confirm these potential benefits in patients with low bone density, compromised healing, or prior implant failure.
本研究评估了 Trabecular Metal™ 牙种植体(TM)高度多孔区域内以及 Tapered Screw-Vent® 牙种植体(TSV)螺纹之间的新骨形成活动和小梁骨微观结构在新鲜犬拔牙窝中的情况。
8 只部分缺牙的狗在双侧下颌新鲜拔牙窝中各植入 4 个种植体(4.1mmD×13mmL)(32 个 TM,32 个 TSV 种植体),并允许其愈合 2、4、8 和 12 周。在处死所有接受 4 个愈合期的狗之前 11 天和 4 天,给予钙黄绿素标记矿化骨。在每个时间间隔内采集的活检标本进行组织学检查。在植入物中部的感兴趣区域(ROI)(6mm 长×0.35mm 深)进行 64 个未染色和 64 个染色切片的组织形态计量学检测。还进行了形貌和化学分析。
组织形态计量学显示,在每个愈合时间点,TM 中的新骨均明显多于 TSV 植入物(p=0.0014,0.0084,0.0218 和 0.0251)。钙黄绿素标记数据显示,在 2、8 和 12 周时,TM 组的新矿化骨多于 TSV 组(p=0.045,0.028,0.002),但在 4 周时则没有(p=0.081)。组织学上,TM 种植体在较早的时间点表现出更多的骨生长和占主导地位的新未成熟编织骨,而 TSV 种植体则没有。代表小梁骨微观结构的参数表明,与 TSV 植入物相比,TM 植入物的新骨形成速度更快。TM 表现出不规则的多面形貌,而 TSV 则呈现相对均匀的微纹理表面。化学分析显示出与每个植入物组成材料相关的峰,TSV 还显示出与钙磷喷砂介质元素相关的峰。
结果表明,与传统的单纯骨整合相比,TM 牙种植体高度多孔中段相关的愈合途径可能使二次种植体稳定性更快更强;然而,需要前瞻性临床研究来确认这些潜在益处在骨密度低、愈合受损或先前种植体失败的患者中的应用。