Narimatsu Ikue, Atsuta Ikiru, Ayukawa Yasunori, Oshiro Wakana, Yasunami Noriyuki, Furuhashi Akihiro, Koyano Kiyoshi
Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
ACS Biomater Sci Eng. 2019 Oct 14;5(10):4976-4984. doi: 10.1021/acsbiomaterials.9b00499. Epub 2019 Sep 13.
Soft tissue barrier around a dental implant plays a crucial role in the success of dental implants because it protects underlying hard tissue structures. A number of surface alteration procedures of implants have been introduced to improve bone-implant contact, but there has been little research on the peri-implant soft tissue (PIS) seal. The present study focuses on the "biologic width" of epithelial and connective tissue seals around implants with various typical surface finishes by testing surfaces that have been machined (Ms), roughened by sandblasting and acid etching (Rs), treated hydrothermally with CaCl (Cs), or anodized (As). Ms, Rs, and As techniques are commonly used to finish surfaces of commercially available dental implants. The Cs technique was reported to produce strong epithelial cell-titanium adhesion. For culture study, rat oral epithelial cells (OECs) and fibroblasts were cultured on Ms, Rs, Cs, and As titanium plates. There was less cell adherence of OECs and more collagen expression when cultured on Rs and As plates than when cultured on Ms and Cs plates. For the in vivo study, implants with Ms, Rs, Cs, and As surfaces were placed in the rats' oral cavity. Although the PIS structure was similar to that around natural teeth, a horseradish peroxide assay revealed that the sealing ability around the Ms and Rs implants was weaker than that around Cs implants. After 16 weeks, Rs implants exhibited peri-implant epithelial apical down-growth and had lost bone support. Thus, although a smooth surface (Ms and Cs) showed better epithelial attachment, rough surfaces (Rs and As) are more suitable for binding to the connective tissue. Strong epithelium-implant attachment seems to be a fundamental defense against foreign body penetration. Selecting suitable surfaces to ensure strong sealing is important for implant success.
牙种植体周围的软组织屏障对牙种植体的成功起着至关重要的作用，因为它能保护下方的硬组织结构。为了改善骨与种植体的接触，人们引入了多种种植体表面改性程序，但对种植体周围软组织（PIS）封闭的研究却很少。本研究通过测试经过机械加工（Ms）、喷砂和酸蚀粗化（Rs）、用CaCl进行水热处理（Cs）或阳极氧化（As）的表面，聚焦于具有各种典型表面处理的种植体周围上皮和结缔组织封闭的“生物学宽度”。Ms、Rs和As技术常用于商业牙种植体表面处理。据报道，Cs技术能产生较强的上皮细胞与钛的粘附力。在培养研究中，将大鼠口腔上皮细胞（OECs）和成纤维细胞培养在Ms、Rs、Cs和As钛板上。与培养在Ms和Cs板上相比，培养在Rs和As板上时OECs的细胞粘附较少，胶原蛋白表达较多。在体内研究中，将具有Ms、Rs、Cs和As表面的种植体植入大鼠口腔。虽然PIS结构与天然牙周围的结构相似，但辣根过氧化物酶检测显示，Ms和Rs种植体周围的封闭能力比Cs种植体周围的弱。16周后，Rs种植体出现种植体周围上皮向根尖方向生长，并失去了骨支持。因此，尽管光滑表面（Ms和Cs）显示出更好的上皮附着，但粗糙表面（Rs和As）更适合与结缔组织结合。上皮与种植体的强附着似乎是抵御异物侵入的基本防御机制。选择合适的表面以确保强封闭对种植体的成功至关重要。
