3D打印和CAD/CAM氧化锆种植体骨结合性能的动物实验评价

摘要/Abstract

摘要： 目的　比较3D打印和计算机辅助设计与制造（computer aided design-computer assomated manufacture CAD/CAM）氧化锆种植体与纯钛种植体在动物体内的骨结合和成骨效果的差异,评价氧化锆种植体骨结合性能。方法　分别将3D打印氧化锆、CAD/CAM种植体和钛种植体各20枚随机植入6只Beagle犬的胫骨内，8周后观察氧化锆种植体的成功率和骨结合能力，并与钛种植体进行比较，观察指标为种植体的成功率、反向扭矩值、骨接触率和种植体周围骨密度。采用SPSS17.0软件包对数据进行统计学分析。结果　3组种植体的成功率均为100%。CAD/CAM氧化锆种植体组的反向转矩值均大于35 N；3D打印氧化锆种植体组的反向转矩值均大于35 N；钛种植体组中2颗种植体的反向转矩值为20～35 N，8颗种植体的反向转矩值大于35 N。组织学观察：3D打印氧化锆种植体、CAD/CAM氧化锆种植体和纯钛种植体的不含骨髓腔骨结合率、分别为（66.35±6.64%）、（61.32±10.41%）和（58.88±25.10%），3D打印氧化锆种植体、CAD/CAM氧化锆种植体和纯钛种植体的含骨髓腔骨结合率分别为（49.57±5.04%）、（42.21±18.58%）和（38.45±23.27%），3D打印氧化锆种植体、CAD/CAM氧化锆种植体和纯钛种植体的平均骨结合率分别为（58.94±6.31%）、（53.56±8.77%）和（48.31±20.76%），3D打印氧化锆种植体、CAD/CAM氧化锆种植体和纯钛种植体的种植体周围骨密度分别为（60.59±7.31%）、（58.50±6.36%）和（58.18±14.80%），差异无显著性（P＞0.05）。结论　氧化锆种植体与纯

关键词: 骨结合, 氧化锆种植体, 不脱钙种植体骨切片

Abstract: Abstract：　Objective　To compare the 3D printed zirconia implants and computer aided design-computer assomated manufacture (CAD/CAM) zirconia implants and pure titanium implants in the differences in osseointegration in animals, and evaluated the osteointegration performance of zirconia implants for zirconia implantation in bones. Methods　Six Beagle dogs were selected, and randomly planted 3D printed zirconia implants, CAD/CAM implants and titanium implants in tibias, 20 for each material. Success rate and osteointegration performance of zirconia implants were evaluated 8 weeks later. Osseointegration performance was compared with titanium implants. The observational indicators of this study were success rate of the bone implant, reverse torque test, bone-to-implant contact rate, and bone density around the implants. SPSS17.0 software package was used for statistical analysis of the data. Results　The success rates of the three groups of bone implants were all 100%.The reverse torque values of CAD / CAM zirconia implant group were all greater than 35 N; the reverse torque values of zirconia implant group by 3D printed technology were all greater than 35 N; the reverse torque value of 2 implants in the titanium implant group was between 20 and 35 N, and the reverse torque value of 8 implants was greater than 35 N. Histological observation findings: The rates of bone osseointegration without marrow cavity of 3D printed zirconia implants, CAD/CAM zirconia implants and pure titanium implants exhibited （66.35±6.64%）、（61.32±10.41%）and（58.88±25.10%）, respectively. The rates of bone osseointegration with marrow cavity of 3D printed zirconia implants, CAD/CAM zirconia implants and pure titanium implants displayed （49.57±5.04%）、（42.21±18.58%）and（38.45±23.27%）, respectively. And the average rate of bone osseointegration of 3D printed zirconia implants, CAD/CAM zirconia implants and pure titanium implants revealed （58.94±6.31%）、（53.56±8.77%） and（48.31±20.76%）, respectively. Moreover, the bone density around 3D printed zirconia implants, CAD/CAM zirconia implants and pure titanium implants demonstrated (60.59±7.31%), (58.50±6.36%) and (58.18±14.80%), respectively. There was no significant difference after data analysis (P> 0.05). Conclusions　Zirconia implants have the similar osseointegration ability as pure titanium implants, and can form close direct bone contact. Therefore, zirconia implants may be an optional material for dental implants.

Key words: Osseointegration, Zirconia implant, Non-decalcified implant bone section

中图分类号:

R782.1

倪王成胡琳驰张维丹周贝贝黄温棉朱秦天余季兰王仁飞. 3D打印和CAD/CAM氧化锆种植体骨结合性能的动物实验评价[J]. 口腔医学, 2021, 41(2): 144-148.

参考文献 21

[1]	P.I. Br?nemark, Hansson B O, Adell R, et al. Osseointegrated Implants in the Treatment of the Edentulous Jaw. Experience from a 10-Year Period[J]. Scand J Plast Reconstr Surg Suppl, 1977,16(10)：1-132.
[2]	Pirker W, Kocher A. Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement[J]. Int J Oral Maxillofac Surg, 2008, 37(3):0-295.
[3]	Javed F , Ahmed H B , Crespi R , et al. Role of primary stability for successful osseointegration of dental implants: Factors of influence and evaluation[J].Interv Med Appl Sci, 2013, 5(4):162-167.
[4]	Wenz H J, Bartsch J, Wolfart S, et al. Osseointegration and clinical success of zirconia dental implants: a systematic review[J]. Int J Prosthodont, 2008, 21(1):27-36.
[5]	王琪,张少锋,白石柱,等.CAD fabrication of the mandible All-on-4 implant photoelastic model%计算机辅助设计制作下颌All-on-4种植义齿光弹模型[J].实用口腔医学杂志, 2015, 000(002):225-229.
[6]	白石柱,刘宝林,陈小文,等.Computer-assisted implantology and CAD/CAM of implant drilling guides%种植导板的制作及CAD-CAM技术的应用[J].实用口腔医学杂志, 2011, 027(001):138-142.
[7]	张磊,叶红强,杨振宇,等.个性化牙种植体三维数字模型的建立[J].北京大学学报(医学版), 2013, 045(001):149-151.
[8]	丁茜,张磊,孙玉春,等.不同表面处理方法对CAD/CAM氧化锆种植体表面显微形貌的影响研究[J].实用口腔医学杂志,2016(6).
[9]	Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: A systematic review[J]. Clin Oral Implants Res, 2009, 20 Suppl 4(Suppl 4):172-184.
[10]	韩建民,林红,洪光.氧化锆种植体的动物及临床应用进展[J].中华口腔医学杂志, 2013, 048(012):769-771.
[11]	Schliephake H, Hefti T, Schlottig F, et al. Mechanical anchorage and peri-implant bone formation of surface-modified zirconia in minipigs[J]. J Clin Periodontol, 2010, 37(9):818-828.
[12]	Sullivan D Y, Sherwood R L, Collins T A, et al. The reverse-torque test: A clinical report[J]. Int J Oral Maxillofac Implants, 1996, 11(2):179-185.
[13]	Shon W J, Chung S H, Kim H K, et al. Peri-implant bone formation of non-thermal atmospheric pressure plasma-treated zirconia implants with different surface roughness in rabbit tibiae[J]. Clin Oral Implants Res, 2014, 25(5):573-579.
[14]	Maeztu M A D, Braceras I, Alava J I , et al. Improvement of osseointegration of titanium dental implant surfaces modified with CO ions: a comparative histomorphometric study in beagle dogs[J]. Int J Oral Maxillofac Surg, 2008, 37(5):0-447.
[15]	Gahlert M, Roehling S, Sprecher C M, et al. In vivo performance of zirconia and titanium implants: A histomorphometric study in mini pig maxillae[J]. Clin Oral Implants Res, 2011, 23(3):281-286.
[16]	Stanic V, Aldini N N, Fini M, et al. Osteointegration of bioactive glass-coated zirconia in healthy bone: an in vivo evaluation[J]. Biomaterials, 2002, 23(18):3833-3841.
[17]	Kohal R J, Wolkewitz M, Hinze M, et al. Biomechanical and histological behavior of zirconia implants: An experiment in the rat[J]. Clin Oral Implants Res, 2009, 20(4):333-339.
[18]	Gahlert M, S R?hling, Wieland M, et al. Osseointegration of zirconia and titanium dental implants: A histological and histomorphometrical study in the maxilla of pigs[J]. Clin Oral Implants Res, 2009, 20(11):1247-1253.
[19]	Strnad Z, Strnad J, C. Povy?il, et al. Effect of plasma sprayed hydroxyapatite coating on osteoconductivity of commercially pure titanium implants[J]. Int J Oral Maxillofac Implants, 2000, 15.
[20]	Stenlund P, Omar O, Brohede U, et al. Bone response to a novel Ti–Ta–Nb–Zr alloy[J]. Acta Biomater , 2015, 20:165-175.
[21]	王晓娜.新型钛铌锆钽硅合金种植体骨结合性能的动物实验研究[D].2016.