Int J Oral Maxillofac Implants. 2020 May/Jun;35(3):503-519. doi: 10.11607/jomi.8110.
Abutment soft tissue integration in the transmucosal area supports the peri-implant tissues, improves esthetics, ensures a soft tissue seal against microorganisms, and preserves crestal bone level. The aim of this systematic review was to systematically analyze the cellular response of fibroblasts on different abutment materials and surface modifications in in vitro studies with a score-based reliability evaluation.
A protocol aiming to answer the following focused question was developed: "What is the effect of different abutment materials and different surface modifications on in vitro cellular response of fibroblasts?" A search through three electronic databases (Medline/PubMed, EMBASE, and Web of Science) was performed using the following search terms: fibroblast, implant, abutment used as the main keywords, with AND/OR as Boolean operators. Only in vitro studies using machined titanium as control surface were included. A quality assessment of the selected studies was performed following the SciRAP method.
Out of a preliminary pool of 97 articles, 21 relevant articles were identified for final evaluation. Cellular response evaluation was investigated as follows: 10 studies compared two or more different materials, 7 assessed mechanical surface modification, 14 weighed chemical or biochemical surface modification, and 3 evaluated surfaces modified by a biophysical procedure. Rather than abutment bulk material, external surface features (collagen coating, electropolishing, plasma cleaning, and laser dimpling) were demonstrated to positively affect cell response (cell attachment, morphology and proliferations, expression of adhesion-related proteins and cytokines), mostly at the early stage. While sandblasting, acid etching, composite coating, nitride coating, and vitamin D presented lower results compared with machined, controversial results were demonstrated by anodization. The mean reporting quality SciRAP score was 78.17 ± 11.89, while the mean methodologic quality SciRAP score was 84.13 ± 12.35. Intrastudy comparison highlighted that the time after seeding chosen to evaluate the fibroblast response varies significantly and seems to deeply influence the response. In fact, due to heterogeneity in the study designs, statistical methods, and reported results, meta-analysis of the data was not possible.
Within the limitation due to the design and heterogeneity of the included studies, it can be speculated that abutment material and its mechanical, physical, and chemical modification influence fibroblast response in vitro, especially in the earlier phases of contact with the abutment surface.
黏膜下区域的基台软组织整合支持种植体周围组织，改善美观，确保软组织对微生物的密封，并维持牙槽骨水平。本系统评价的目的是通过基于评分的可靠性评估，系统分析不同基台材料和表面改性在体外研究中对成纤维细胞的细胞反应。
制定了一项旨在回答以下重点问题的方案：“不同基台材料和不同表面改性对成纤维细胞体外细胞反应的影响是什么？”通过以下搜索词在三个电子数据库（Medline/PubMed、EMBASE 和 Web of Science）中进行了搜索：成纤维细胞、种植体，基台用作主要关键词，并使用 AND/OR 作为布尔运算符。仅纳入使用机械加工钛作为对照表面的体外研究。根据 SciRAP 方法对选定的研究进行了质量评估。
在初步的 97 篇文章中，确定了 21 篇相关文章进行最终评估。细胞反应评估如下：10 项研究比较了两种或更多种不同的材料，7 项研究评估了机械表面改性，14 项研究评估了化学或生化表面改性，3 项研究评估了通过生物物理程序改性的表面。与基台整体材料相比，外部表面特征（胶原涂层、电化学抛光、等离子体清洁和激光压花）被证明能更有效地影响细胞反应（细胞附着、形态和增殖、粘附相关蛋白和细胞因子的表达），尤其是在早期阶段。虽然喷砂、酸蚀、复合涂层、氮化涂层和维生素 D 的效果与机械加工相比较差，但阳极氧化的结果存在争议。平均报告质量 SciRAP 得分为 78.17 ± 11.89，平均方法学质量 SciRAP 得分为 84.13 ± 12.35。研究内比较表明，选择评估成纤维细胞反应的接种后时间差异很大，似乎对反应有很大影响。事实上，由于研究设计、方法和报告结果的异质性，不可能对数据进行荟萃分析。
在纳入研究的设计和异质性的限制内，可以推测基台材料及其机械、物理和化学改性会影响体外成纤维细胞的反应，尤其是在与基台表面接触的早期阶段。
