不同時期的負荷對骨頭：種植體交介面的影響

The Effect of Different Timing of Loading to the Bone-Implant Interface

何政昇(Cheng-Sheng Ho)

《中華民國牙周病醫學會雜誌》 7卷3期 (2002/09) Pp. 191-214

https://doi.org/10.6121/CJP.200209_7(3).0007

摘要

在傳統的人工植牙治療中，通常在植入後4到6個月，俟種植體周圍的齒槽骨完全癒合後，才進行功能性的負荷。體與種植體的交介面以兩種型式存在：骨整合的型式與纖維組織包被的型式。初期骨頭癒合的反應主要包括了在骨膜及骨內膜表面進行的骨塑形以及隨即發生於後的種植體－骨頭交介面的骨重塑生長。由於種植體行使功能時，種植體會將所承受的咬合負荷經由種植體本身或種植體－支柱的交介面傳導到周遭的骨頭結構上，進而影響到骨頭癒合時的細胞活動的變化。在不同的骨頭癒合的時期施于咬合負荷也肯定會對於細胞有不同程度的影響。在實驗室中可使用高度顯像的顯微放射線技術配合組織標定的技術來評估植體植入後周圍齒槽骨的癒合、成熟、以及對不同時期咬合負荷的適應程度。基於骨頭癒合的觀點，何時為最好的時機將種植體銜術支柱進行咬合功能的負荷來達到長期植體的成功預後將會在本文中討論。

關鍵字

功能性負荷 ； 骨塑型 ； 骨重塑生長 ； 種植體-支柱交介面

並列摘要

The loading time for conventional implant treatment usually takes 4 to 6 months after the implant was installed to insure the complete healing of alveolar bone around implant. Bone-implant interface may be ended up with either rigid bone fixation (osseo-integration) of fibro-osseous integration (fibro-encapsulation). The initial osseous healing involves the bone modeling at the periosteal and endosteal surfaces followed by the bone remodeling occurred at the non-vital osseous interface. Under functional loading, the implant receives the stress distributed from the implant body, implant-abutment connection, and the apical part of implant into the surrounding bone structure and further influences the activities of cells during wound healing. The cellular activities within bone may also be influenced by different timing of loading during healing. High resolution micro-radiography and histological labeling are methods for assessing the mechanism and timing of osseous healing, maturation, and adaptation under different time of loading. Based on the point of bone healing, the proper time for implant to receive the functional loading in order to achieve the long-term prognosis will be discussed further.

並列關鍵字

functional loading ； bone modeling ； bone remodeling ； bone-implant interface