牙种植体形态结构设计的研究进展

摘要/Abstract

摘要： 种植体的初期稳定性和边缘骨水平与周围骨结合密切相关，是临床诊疗中获得较高存活率和成功率的关键因素。牙种植体形态和结构设计包括种植体外部形态、颈部设计、螺纹和凹槽设计、直径和长度、与基台的连接方式等，这些设计会对初期稳定性和边缘骨水平产生不同的影响，从而影响种植体-骨界面的整体稳定性。该文就牙种植体形态结构设计的研究进展进行综述，为临床医生在诊疗过程中选择合适的种植体提供一定帮助。

关键词: 种植体, 锥形, 螺纹, 初期稳定性, 边缘骨水平

Abstract: The initial stability and marginal bone level of implants are closely related to surrounding osseointegration, which is a key factor for achieving a higher survival rate and success rate in clinical diagnosis and treatment. The morphological and structural design of dental implants includes the external shape, neck design, screw thread and groove design, diameter and length, and the connection method with the abutment. These elements can have different effects on the initial stability and the marginal bone level, thereby affecting the overall stability of the implantbone interface. This article reviews the progress of research on the morphological and structural design of dental implants, and provides a reference for clinicians in the selection of suitable implants.

Key words: implant, taper, screw thread, initial stability, marginal bone level

中图分类号:

R739.8

杜巧琳顾新华. 牙种植体形态结构设计的研究进展[J]. 口腔医学, 2021, 41(5): 475-480.

参考文献 57

[1]	Hamada Y, Shin D, John V.Peri-implant disease: A significant complication of dental implant supported restorative treatment[J].J Indiana Dent Assoc, 2016, 95(1):31-38
[2]	Ogle OE.Implant surface material,design,and osseointegration[J].Dent Clin N Am, 2015, 59(2):505-520
[3]	Esposito M, Ardebili Y, Worthington HV.Interventions for replacing missing teeth: Different types of dental implants[J]. Cochrane Database Syst Rev, 2014(7): CD003815.
[4]	Lovatto ST, Bassani R, Sarkis-Onofre R, et al.Influence of different implant geometry in clinical longevity and maintenance of marginal bone: A systematic review[J].J Prosthodont, 2019, 28(2):e713-e721
[5]	Waechter J, Madruga MDM, Carmo Filho LCD, et al.Comparison between tapered and cylindrical implants in the posterior regions of the mandible: A prospective,randomized,split-mouth clinical trial focusing on implant stability changes during early healing[J].Clin Implant Dent Relat Res, 2017, 19(4):733-741
[6]	Schiegnitz E, Al-Nawas B, Tegner A, et al.Clinical and radiological long-term outcome of a tapered implant system with special emphasis on the influence of augmentation procedures[J].Clin Implant Dent Relat Res, 2016, 18(4):810-820
[7]	Wilson TG, Miller RJ, Trushkowsky R, et al.Tapered implants in dentistry: Revitalizing concepts with technology: A review[J].Adv Dent Res, 2016, 28(1):4-9
[8]	Toyoshima T, Wagner W, Klein MO, et al.Primary stability of a hybrid self-tapping implant compared to a cylindrical non-self-tapping implant with respect to drilling protocols in an ex vivo model[J].Clin Implant Dent Relat Res, 2011, 13(1):71-78
[9]	Saeidi Pour R, Freitas Rafael C, Engler MLPD, et al.Historical development of root analogue implants: A review of published papers[J].Br J Oral Maxillofac Surg, 2019, 57(6):496-504
[10]	Cheng YC, Lin DH, Jiang CP, et al.Dental implant customization using numerical optimization design and 3-dimensional printing fabrication of zirconia ceramic[J].Int J Numer Methods Biomed Eng, 2017, 33(5):e2820-
[11]	Yasutake M, Kuroshima S, Ishimoto T, et al.Influence of implant neck design on bone formation under mechanical repetitive loading: Histomorphometric and microcomputed tomographic studies in rabbit tibiae[J].Implant Dent, 2016, 25(2):171-178
[12]	Valles C, Rodríguez-Ciurana X, Clementini M, et al.Influence of subcrestal implant placement compared with equicrestal position on the peri-implant hard and soft tissues around platform-switched implants: A systematic review and meta-analysis[J].Clin Oral Investig, 2018, 22(2):555-570
[13]	宿玉成.口腔种植学[M]. 2版. 北京: 人民卫生出版社, 2014.
[14]	Buser D, Mericske-Stern R, Dula K, et al.Clinical experience with one-stage, non-submerged dental implants[J]. Adv Dent Res, 1999, 13: 153-161.
[15]	Gulati M, Govila V, Verma S, et al.In vivo evaluation of two-piece implants placed following one-stage and two-stage surgical protocol in posterior mandibular regionassessment of alterations in crestal bone level[J].Clin Implant Dent Relat Res, 2015, 17(5):854-861
[16]	Troiano G, Lo Russo L, Canullo L, et al.Early and late implant failure of submerged versus non-submerged implant healing: A systematic review,meta-analysis and trial sequential analysis[J].J Clin Periodontol, 2018, 45(5):613-623
[17]	林野.当代牙种植体设计进步与临床意义[J].华西口腔医学杂志, 2017, 35(1):18-28
[18]	Sánchez-Siles M, Mu?oz-Cámara D, Salazar-Sánchez N, et al.Incidence of peri-implantitis and oral quality of life in patients rehabilitated with implants with different neck designs: A 10-year retrospective study[J].J Cranio - Maxillofac Surg, 2015, 43(10):2168-2174
[19]	Canullo L, Caneva M, Tallarico M.Ten-year hard and soft tissue results of a pilot double-blinded randomized controlled trial on immediately loaded post-extractive implants using platform-switching concept[J].Clin Oral Implant Res, 2017, 28(10):1195-1203
[20]	Schiegnitz E, Noelken R, Moergel M, et al.Survival and tissue maintenance of an implant with a sloped configurated shoulder in the posterior mandible: A prospective multicenter study[J].Clin Oral Implant Res, 2017, 28(6):721-726
[21]	den Hartog L, Meijer HJA, Vissink A, et al.Anterior single implants with different neck designs: 5 Year results of a randomized clinical trial[J].Clin Implant Dent Relat Res, 2017, 19(4):717-724
[22]	Abuhussein H, Pagni G, Rebaudi A, et al.The effect of thread pattern upon implant osseointegration[J].Clin Oral Implant Res, 2010, 21(2):129-136
[23]	Geramizadeh M, Katoozian H, Amid R, et al.Finite element analysis of dental implants with and without microthreads under static and dynamic loading[J].J Long - Term Eff Med Implant, 2017, 27(1):25-35
[24]	Nickenig HJ, Wichmann M, Happe A, et al.A 5-year prospective radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthreaded implants using digitized panoramic radiographs[J].J Cranio - Maxillofac Surg, 2013, 41(7):564-568
[25]	Calvo-Guirado J, Jiménez-Soto R, Pérez Albacete-Martínez C, et al.Influence of implant neck design on peri-implant tissue dimensions: A comparative study in dogs[J].Materials, 2018, 11(10):2007-
[26]	Patil V, Naik N, Gadicherla S, et al.Biomechanical behavior of bioactive material in dental implant: A three-dimensional finite element analysis[J]. Sci World J, 2020, 2020: 1-9.
[27]	Steigenga J, Al-Shammari K, Misch C, et al.Effects of implant thread geometry on percentage of osseointegration and resistance to reverse torque in the Tibia of rabbits[J].J Periodontol, 2004, 75(9):1233-1241
[28]	Ormianer Z, Matalon S, Block J, et al.Dental implant thread design and the consequences on long-term marginal bone loss[J].Implant Dent, 2016, 25(4):471-477
[29]	Orsini E, Giavaresi G, Trirè A, et al.Dental implant thread pitch and its influence on the osseointegration process: An in vivo comparison study[J].Int J Oral Maxillofac Implant, 1900, 27(2):383-392
[30]	Ao JH, Li T, Liu YP, et al.Optimal design of thread height and width on an immediately loaded cylinder implant: A finite element analysis[J].Comput Biol Med, 2010, 40(8):681-686
[31]	Ma P, Xiong W, Tan BS, et al.Influence of thread pitch, Helix angle, and compactness on micromotion of immediately loaded implants in three types of bone quality: A three-dimensional finite element analysis[J]. Biomed Res Int, 2014, 2014: 983103.
[32]	Calì M, Zanetti EM, Oliveri SM, et al.Influence of thread shape and inclination on the biomechanical behaviour of plateau implant systems[J].Dent Mater, 2018, 34(3):460-469
[33]	Gonzalez-Serrano J, Ortega-Aranegui R, Lopez-Quiles J.In vitro comparison of primary stability of two implant designs in D3 bone[J]. Med Oral, 2017: 0.
[34]	Kim DG, Kim KH, Jo Y, et al.Bone regeneration into side openings and hollow inner channel of a dental implant[J]. J Mech Behav Biomed Mater, 2020, 101: 103416.
[35]	Zhu JW, Yang DW, Ma F.Feasibility study of a partially hollow configuration for zirconia dental implants[J].J Oral Maxillofac Surg, 2010, 68(2):399-406
[36]	Wu SW, Lee CC, Fu PY, et al.The effects of flute shape and thread profile on the insertion torque and primary stability of dental implants[J].Med Eng Phys, 2012, 34(7):797-805
[37]	Markovi? A, Calvo-Guirado JL, Lazi? Z, et al.Evaluation of primary stability of self-tapping and non-self-tapping dental implantsA 12-week clinical study[J].Clin Implant Dent Relat Res, 2013, 15(3):341-349
[38]	Shemtov-Yona K, Rittel D, Levin L, et al.Effect of dental implant diameter on fatigue performancepart I: Mechanical behavior[J].Clin Implant Dent Relat Res, 2014, 16(2):172-177
[39]	El-Anwar MI, El-Zawahry MM, Ibraheem EM, et al.New dental implant selection criterion based on implant design[J].Eur J Dent, 2017, 11(2):186-191
[40]	Edher F, Nguyen CT.Short dental implants: A scoping review of the literature for patients with head and neck cancer[J].J Prosthet Dent, 2018, 119(5):736-742
[41]	Gracis S, Michalakis K, Vigolo P, et al.Internal vs. external connections for abutments/reconstructions: A systematic review[J]. Clin Oral Implant Res, 2012, 23: 202-216.
[42]	林野.口腔种植学[M]. 北京: 北京大学医学出版社, 2013.
[43]	Ranieri R, Ferreira A, Souza E, et al.The bacterial sealing capacity of morse taper implant-abutment systems in vitro[J].J Periodontol, 2015, 86(5):696-702
[44]	Aloise JP, Curcio R, Laporta MZ, et al.Microbial leakage through the implant-abutment interface of morse taper implants in vitro[J].Clin Oral Implant Res, 2010, 21(3):328-335
[45]	Liu Y, Wang JW.Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck[J]. Arch Oral Biol, 2017, 83: 153-160.
[46]	Macedo JP, Pereira J, Vahey BR, et al.Morse taper dental implants and platform switching: The new paradigm in oral implantology[J].Eur J Dent, 2016, 10(1):148-154
[47]	Szyszkowski A, Kozakiewicz M.Effect of implant-abutment connection type on bone around dental implants in long-term observation: Internal cone versus internal hex[J].Implant Dent, 2019, 28(5):430-436
[48]	lvarez-Arenal á, Segura-Mori L, Gonzalez-Gonzalez I, et al.Stress distribution in the transitional peri-implant bone in a single implant-supported prosthesis with platform-switching under different angulated loads[J].Odontology, 2017, 105(1):68-75
[49]	Gupta S, Sabharwal R, Nazeer J, et al.Platform switching technique and crestal bone loss around the dental implants: A systematic review[J].Ann Afr Med, 2019, 18(1):1-6
[50]	Salamanca E, Lin JCY, Tsai CY, et al.Dental implant surrounding marginal bone level evaluation: Platform switching versus platform matching-one-year retrospective study[J]. Biomed Res Int, 2017, 2017: 7191534.
[51]	Sasada Y, Cochran D.Implant-abutment connections: A review of biologic consequences and peri-implantitis implications[J].Int J Oral Maxillofac Implants, 2017, 32(6):1296-1307
[52]	Canullo L, Penarrocha-Oltra D, Soldini C, et al.Microbiological assessment of the implant-abutment interface in different connections: Cross-sectional study after 5 years of functional loading[J].Clin Oral Implant Res, 2015, 26(4):426-434
[53]	Khorshidi H, Raoofi S, Moattari A, et al.In vitro evaluation of bacterial leakage at implant-abutment connection: An 11-degree morse taper compared to a butt joint connection[J]. Int J Biomater, 2016, 2016: 8527849.
[54]	Passos SP, Gressler May L, Faria R, et al.Implant-abutment gap versus microbial colonization: Clinical significance based on a literature review[J].J Biomed Mater Res, 2013, 101(7):1321-1328
[55]	Ericsson I, Persson LG, Berglundh T, et al.Different types of inflammatory reactions in peri-implant soft tissues[J].J Clin Periodontol, 1995, 22(3):255-261
[56]	Baixe S, Tenenbaum H, Etienne O.Microbial contamination of the implant-abutment connections: Review of the literature[J].Revue De Stomatol De Chir Maxillo - Faciale et De Chir Orale, 2016, 117(1):20-25
[57]	Koutouzis T.Implant-abutment connection as contributing factor to peri-implant diseases[J].Periodontol, 2019, 81(1):152-166