Le Thieu Minh Khai, Homayouni Amin, Hæren Lena Ringsby, Tiainen Hanna, Verket Anders, Ellingsen Jan Eirik, Rønold Hans Jacob, Wohlfahrt Johan Caspar, Cantalapiedra Antonio Gonzalez, Muñoz Fernando Maria Guzon, Mendaña Maria Permuy, Lyngstadaas Ståle Petter, Haugen Håvard Jostein
Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway.
Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Biomater Res. 2021 Nov 25;25(1):43. doi: 10.1186/s40824-021-00245-3.
Insufficient bone volume around an implant is a common obstacle when dental implant treatment is considered. Limited vertical or horizontal bone dimensions may lead to exposed implant threads following placement or a gap between the bone and implant. This is often addressed by bone augmentation procedures prior to or at the time of implant placement. This study evaluated bone healing when a synthetic TiO block scaffold was placed in circumferential peri-implant defects with buccal fenestrations.
The mandibular premolars were extracted and the alveolar bone left to heal for 4 weeks prior to implant placement in six minipigs. Two cylindrical defects were created in each hemi-mandible and were subsequent to implant placement allocated to treatment with either TiO scaffold or sham in a split mouth design. After 12 weeks of healing time, the samples were harvested. Microcomputed tomography (MicroCT) was used to investigate defect fill and integrity of the block scaffold. Distances from implant to bone in vertical and horizontal directions, percentage of bone to implant contact and defect fill were analysed by histology.
MicroCT analysis demonstrated no differences between the groups for defect fill. Three of twelve scaffolds were partly fractured. At the buccal sites, histomorphometric analysis demonstrated higher bone fraction, higher percentage bone to implant contact and shorter distance from implant top to bone 0.5 mm lateral to implant surface in sham group as compared to the TiO group.
This study demonstrated less bone formation with the use of TiO scaffold block in combination with implant placement in cylindrical defects with buccal bone fenestrations, as compared to sham sites.
在考虑进行牙种植治疗时，种植体周围骨量不足是一个常见的障碍。垂直或水平骨尺寸受限可能导致种植体植入后种植体螺纹暴露或骨与种植体之间出现间隙。这通常通过在种植体植入前或植入时进行骨增量手术来解决。本研究评估了在有颊侧开窗的种植体周围环形缺损处放置合成TiO块状支架时的骨愈合情况。
在六只小型猪中，拔除下颌前磨牙，让牙槽骨愈合4周后再植入种植体。在每侧半下颌骨上制造两个圆柱形缺损，在种植体植入后，采用双侧对照设计将其分配至TiO支架治疗组或假手术组。愈合12周后，采集样本。使用微型计算机断层扫描（MicroCT）来研究缺损填充情况和块状支架的完整性。通过组织学分析种植体在垂直和水平方向到骨的距离、骨与种植体接触的百分比以及缺损填充情况。
MicroCT分析显示两组在缺损填充方面无差异。十二个支架中有三个部分断裂。在颊侧部位，组织形态计量学分析表明，与TiO组相比，假手术组的骨分数更高、骨与种植体接触的百分比更高，且在种植体表面外侧0.5毫米处从种植体顶部到骨的距离更短。
本研究表明，与假手术部位相比，在有颊侧骨开窗的圆柱形缺损中，使用TiO支架块结合种植体植入时骨形成较少。
