Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India.
ACS Biomater Sci Eng. 2024 Apr 8;10(4):1966-1987. doi: 10.1021/acsbiomaterials.3c01555. Epub 2024 Mar 26.
A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.
经皮骨锚定金属假体与硬组织和软组织的整体生物整合决定了其在人体中的耐久性。虽然钛 (Ti) 几乎解决了骨整合问题，但经皮金属假体的软组织整合仍然是一个长期存在的问题。与生物经皮结构（指甲和牙齿）中牢固的软组织密封不同，皮肤对外来钛 (Ti) 的异物反应会导致炎症、表皮向下生长和植入物周围软组织密封不良。本文综述了各种用于骨整合、软组织整合和抗细菌附着的植入物表面处理/织构和涂层。虽然 SLA（大粒度喷砂和酸蚀）的表面微观粗糙度和多孔磷酸钙 (CaP) 涂层可改善 Ti 的骨整合，但光滑和纹理化的氧化钛纳米孔、纳米管、微槽和生物分子涂层可促进软组织附着。然而，与天然牙齿相比，植入物周围软组织密封不良可能导致植入物周围炎。为此，提出了应用具有软组织强附着力、机械弹性、耐久性、抗菌和免疫调节特性的智能多功能生物粘合剂，以将软组织附着到金属假体上。
