酸鹼熱複合表面處理對植體骨整合之影響:動物實驗

在近十幾年來，人工植牙廣為流行，已經成為缺牙區域贗復重要的方法之一。為了提供給患者一個良好的咀嚼功能，且能夠快速的接上贗復物使其受力，植體的穩定度扮演了一個重要的角色。所以如何加強植體與骨頭整合的程度，以及提升骨整合的速度，在植體的穩定度上便是個關鍵。因此，植體表面的設計以及處理成為一個重要的問題。本研究的目的在於評估利用不同方法的表面處理，作用在相同型態的人工牙根，來探討對於骨頭的初步穩定度及骨整合的影響。其方法是用兩款植體，分別為經酸、鹼、熱(AAH)處理，以及經噴砂後再酸蝕(SLA)處理，來跟Straumann公司的SLA®植體進行比較。利用18隻米格魯犬，拔除其下顎牙齒。每隻狗分別在下顎兩側各植入AAH表面處理植體及SLA表面處理植體各一支，再各植入市售Straumann公司的SLA®一支進行比較。於植體植入前後，進行臨床評估、osstell®共振頻率測量、以及醫學影像紀錄。並於植入後一週、二週、四週、八週、十二週、二十四週等時間點犧牲動物，來進行組織標本觀察。結果顯示，在存活率方面，實驗組之AAH表面處理植體僅失敗了一支，優於對照組。在共振頻率方面，Straumann公司的SLA®表面處理的植體，在剛植入時的共振頻率測量皆優於實驗組之植體，顯示實驗組植體的初步穩定度尚劣於SLA®植體。但是經一週、二週、四週、八週、十二週、二十四週後觀察，AAH植體其共振頻率測量有優於SLA®趨勢，SLA植體則是略弱於SLA®。而在骨與植體接觸部分，實驗組之AAH表面處理植體表現則是優於對照組。代表著AAH表面處理植體，在表面處理上具有相當程度的優勢，可以與市售植體相比擬。

關鍵字

骨整合；表面處理； SLA ； AAH

並列摘要

Objectives Over the past few decades, dental implant has become a predictable and widely accepted treatment for fully and partially edentulous patients. In order to provide a better environment for chewing, the stability of implant has play an important role. The term of “osseointegration” which defines as a process in a direct connection between implant and living bone without any soft tissue component interference. Nowadays, the clinical goal of dental implant surgery is the achievement of osseointegration. The higher the degree of osseointegration, the higher the mechanical stability and the successful probability of implants are. It is related to surface design and treatment of implant, so the purpose of this study is to evaluate the different surface treatment on osseointegartion. Material and methods Two different surface treatment implant were used as the experimental group. One is AAH(Acid, Alkaline, Heat) type, the other is SLA (Sand-blasted, Large grit, Acid etched) type. They have the same implant design with different surface treatment. The control group is the Straumann SLA implant. The three type implant have the same width and length which is 3mm x 8mm. We use 18 beagle dogs, each of them were inserted 6 implants, which is included two experimental groups and one control group. The assessments of implants are including clinical evaluation, survival rate, resonance frequency analysis, and photo record. The dogs were sacrificed at the time interval of 1, 2, 4, 8, 12, 24 weeks for further histological analysis. Results In the survival rate, the AAH surface treatment only lose one implant. On the aspect of ISQ, the value of AAH surface treatment arise in the past weeks, even exceed the control group. On the BIC aspect, AAH surface treatment has resided in the leading position. Conclusion The potential for AAH chemical modification of the implant surface to alter biologic events during the osseointegration process and demonstrate success similar to those observed for implants with an SLA surface

並列關鍵字

osseointegration ； surface treatment ； AAH ； SLA

參考文獻

1. Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A: Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969, 3(2):81-100.

2. Van de Putte KA, Urist MR: Osteogenesis in the interior of intramuscular implants of decalcified bone matrix. Clin Orthop Relat Res 1965, 43:257-270.

3. Urist MR: Bone: formation by autoinduction. Science 1965, 150(698):893-899.

4. Urist MR, Silverman BF, Buring K, Dubuc FL, Rosenberg JM: The bone induction principle. Clin Orthop Relat Res 1967, 53:243-283.

5. Parr GR, Gardner LK, Toth RW: Titanium: the mystery metal of implant dentistry. Dental materials aspects. J Prosthet Dent 1985, 54(3):410-414.

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酸鹼熱複合表面處理對植體骨整合之影響:動物實驗

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