Department of Stomatology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing 400042, China.
College of Stomatology, Chongqing Medical University, Chongqing 401147, China.
ACS Biomater Sci Eng. 2022 Feb 14;8(2):912-920. doi: 10.1021/acsbiomaterials.1c00962. Epub 2022 Jan 5.
Subperiosteal implants represent an alternative implant approach for cases with severe bone atrophy. Although some successful clinical cases have been reported, the biomechanical stability of subperiosteal implants remains unclear, and more data are needed to confirm the feasibility of this approach. Therefore, this study investigated the biomechanical characteristics of subperiosteal implants based on histological observation, clinical cases, and finite element analysis. Finite element analysis indicated that subperiosteal implants with a lattice-like structure could better disperse the stress to the underlying bone surface. A novel customized subperiosteal implant was then digitally designed and fabricated using an additive manufacturing technology. Six beagle dogs received such customized subperiosteal implants. Histological and microcomputed tomography examination showed new bone growth into and around the implant. Patient-specific subperiosteal implants were placed into the edentulous mandibular bone, with immediate loading. The implant was functional, without pain or infection, over a 12 month observation period. Images taken 12 months post-operatively showed new bone formation and osseointegration of the device. This indicated that 3D-printed lattice-like subperiosteal implants have sufficient stability for the rehabilitation of severely atrophic ridges.
骨膜下种植体为严重骨萎缩病例提供了一种替代种植体方法。尽管已有一些成功的临床病例报告,但骨膜下种植体的生物力学稳定性仍不清楚,需要更多的数据来证实这种方法的可行性。因此,本研究基于组织学观察、临床病例和有限元分析,研究了骨膜下种植体的生物力学特性。有限元分析表明,具有格子状结构的骨膜下种植体能更好地将应力分散到下方的骨表面。然后,使用增材制造技术对一种新型定制骨膜下种植体进行了数字化设计和制造。六只比格犬接受了这种定制的骨膜下种植体。组织学和微计算机断层扫描检查显示,新骨长入并环绕植入物。将个体化的骨膜下种植体放置在下颌骨无牙区,即刻负载。在 12 个月的观察期内,种植体功能正常,无疼痛或感染。术后 12 个月拍摄的图像显示新骨形成和装置的骨整合。这表明 3D 打印的格子状骨膜下种植体具有足够的稳定性,可用于严重萎缩牙槽嵴的修复。
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