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在体评价不同保护技术在种植导板制备过程中减少钛颗粒污染的效果。

In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty.

机构信息

Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland.

Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland.

出版信息

Clin Oral Investig. 2023 Aug;27(8):4205-4213. doi: 10.1007/s00784-023-05037-8. Epub 2023 May 4.

Abstract

OBJECTIVES

Our aim is to study titanium remains in a bone model during standardized implantoplasty under different isolation and protective modalities.

MATERIAL AND METHODS

Forty implants were placed in artificial spongy bone blocks mimicking a horizontal bone loss and implant neck protrusion of 5 mm. Samples were randomly divided into four groups (n = 10), which were treated as follows: rubber dam (A), a dental adhesive paste (B), bone wax (C), and an unprotected positive control (D). Implantoplasty was performed using carbide and diamond burs under strict water cooling and standardized suction. After removal of the respective isolation materials, the bone blocks were thoroughly rinsed with tap water for 3 min and titanium chips were collected using a filter integrated in the model. The filter paper was removed and dissolved in 37% hydrochloric acid for 2 h at 120 °C and the titanium remnants were quantified using atomic absorption spectrometry.

RESULTS

None of the test groups were able to completely prevent titanium particle contamination. Rubber dam (691 ± 249 µg) and bone wax (516 ± 157 µg) were found to be significantly more protective than the positive control (2313 ± 747 µg) (p < 0.001) with respect to the amount of titanium particles that remained in the bone model after implantoplasty. The adhesive paste group (1863.5 ± 538 µg) was not significantly different from the positive control (p = 0.19).

CONCLUSIONS

Despite some limitations of the present study, titanium particles resulting from a standardized implantoplasty can be assumed to be significantly reduced when the tissues/bone were protected with rubber dam and bone wax, or a combination, depending on individual accessibility.

CLINICAL RELEVANCE

Tissue protective measures to reduce or avoid particle contamination during implantoplasty is possible and should be considered and further clinically assessed to avoid iatrogenic inflammatory reactions.

摘要

目的

本研究旨在研究不同隔离和保护方式下,标准化种植体预备过程中钛在骨模型中的残留情况。

材料和方法

将 40 个种植体植入模仿水平骨缺损和 5mm 种植体颈部突出的人造海绵骨块中。将样本随机分为四组(n=10),分别采用以下方法处理:橡皮障(A)、牙科黏合剂糊剂(B)、骨蜡(C)和未保护的阳性对照(D)。在严格的水冷和标准化抽吸下,使用碳化硅和金刚石钻头进行种植体预备。去除隔离材料后,将骨块用自来水彻底冲洗 3 分钟,并使用模型中集成的过滤器收集钛屑。将滤纸取出,溶解在 37%盐酸中,在 120°C 下加热 2 小时,使用原子吸收光谱法定量钛残余物。

结果

没有一个实验组能够完全防止钛颗粒污染。与阳性对照组(2313±747μg)相比,橡皮障(691±249μg)和骨蜡(516±157μg)组的钛颗粒残留量明显较少(p<0.001)。黏合剂糊剂组(1863.5±538μg)与阳性对照组无显著差异(p=0.19)。

结论

尽管本研究存在一些局限性,但当组织/骨采用橡皮障和骨蜡或联合保护时,可假定标准化种植体预备过程中产生的钛颗粒会显著减少,具体取决于个体的可操作性。

临床意义

在种植体预备过程中采用组织保护措施来减少或避免颗粒污染是可行的,应予以考虑,并进一步进行临床评估,以避免医源性炎症反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/271d/10415425/4cd13fa16dc5/784_2023_5037_Fig1_HTML.jpg

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