de Souza Vilton Zimmerman, Manfro Rafael, Teixeira Lucas Novaes, Elias Carlos Nelson, Joly Julio Cesar, Martinez Elizabeth Ferreira
Int J Oral Maxillofac Implants. 2025 Jun 25;0(0):1-27. doi: 10.11607/jomi.11301.
This clinical trial aimed to assess the effects of anodized prosthetic abutments versus machined abutments on peri-implant connective tissue.
Following dental implant placement and osseointegration, custom healing abutments with machined surfaces (G1) and anodized surface treatment (G2) were attached to 28 dental implants. After a soft tissue healing period of approximately 30 days (±7 days), 5 mm circular biopsies were taken from the peri-implant tissue and the area adjacent to the prosthetic abutment. Histological analysis was conducted on the stained specimens using hematoxylin- eosin, focusing on parameters such as vascular proliferation, the presence of polymorphonuclear and mononuclear cells, collagen fibrils, and re-epithelialization. A grading scale from 0 to 3 evaluated the extent of the inflammatory response. Masson's trichrome staining was used to analyze collagen fiber presence and organization, while immunohistochemical staining assessed the expression of beta-catenin and CD34. The prosthetic abutments were evaluated through electron microscopy and three-dimensional roughness analysis.
Histological findings revealed that peri-implant tissue adjacent to anodized surfaces exhibited epithelial stratification and a parakeratin layer in the lamina propria. Both groups displayed a typical mononuclear lymphocytic inflammatory infiltrate, but the intensity was significantly higher adjacent to the machined abutment (p<0.05). Quantification of blood vessels indicated increased immunopositivity for CD34 in G2 compared to G1 (p<0.05). Immunolabeling of beta-catenin was detected in the epithelial tissue, showing weak intensity in G1 and strong intensity in G2. The average surface roughness (Ra) measurements were determined to be 0.097 (0.006) µm for G1 and 0.182 (0.008) µm for G2.
Anodized surfaces are promising and exhibit beneficial effects on peri-implant tissue healing. They play an important role in preserving the epithelial mucosal integrity and functionality near the prosthetic abutment, thereby potentially minimizing the risks of mucositis, peri-implantitis, and implant failure.
本临床试验旨在评估阳极氧化修复基台与机械加工基台对种植体周围结缔组织的影响。
在植入牙种植体并完成骨结合后,将具有机械加工表面的定制愈合基台(G1组)和经过阳极氧化表面处理的愈合基台(G2组)连接到28颗牙种植体上。在约30天(±7天)的软组织愈合期后,从种植体周围组织和修复基台相邻区域取5mm圆形活检组织。使用苏木精-伊红对染色标本进行组织学分析,重点关注血管增殖、多形核细胞和单核细胞的存在、胶原纤维以及再上皮化等参数。采用0至3级评分量表评估炎症反应程度。使用马松三色染色法分析胶原纤维的存在和组织情况,同时通过免疫组织化学染色评估β-连环蛋白和CD34的表达。通过电子显微镜和三维粗糙度分析对修复基台进行评估。
组织学结果显示,与阳极氧化表面相邻的种植体周围组织在固有层表现出上皮分层和不全角化层。两组均显示出典型的单核淋巴细胞炎性浸润,但机械加工基台相邻处的炎症强度明显更高(p<0.05)。血管定量分析表明,与G1组相比,G2组中CD34的免疫阳性率增加(p<0.05)。在上皮组织中检测到β-连环蛋白的免疫标记,G1组强度较弱,G2组强度较强。G1组的平均表面粗糙度(Ra)测量值为0.097(0.006)µm,G2组为0.182(0.008)µm。
阳极氧化表面前景良好,对种植体周围组织愈合具有有益作用。它们在维持修复基台附近上皮黏膜的完整性和功能方面发挥重要作用,从而有可能将黏膜炎、种植体周围炎和种植体失败的风险降至最低。