三维打印口腔修复种植体的研究进展

doi:10.13591/j.cnki.kqyx.2024.02.015

摘要/Abstract

摘要：

三维打印是计算机辅助制造的一种,通过三维打印设备,将数字化设计转化为实体。随着各种数字化手段的发展,三维打印已广泛应用于口腔修复体的制作。口腔种植义齿被称作人类第二副牙齿,以其美观、舒适等优点成为临床修复热点。目前,口腔种植体主要采用传统方法制造,三维打印可以提高种植体的个性化程度和制作效率。众多研究已证实,三维打印种植体是可行的,但在种植体设计、表面修饰等方面尚未有统一结论。本文通过阐述三维打印金属及全瓷种植体的最新研究进展,旨在带来种植体材料选择、制作工艺、表面设计及修饰等方面的思考,为三维打印种植体的进一步研究提供参考,以期更好地服务于临床。

关键词: 口腔种植体, 三维打印, 增材制造, 钛种植体, 陶瓷

Abstract:

3D printing is a kind of computer aided manufacturing, which transforms digital model into green body through 3D printing equipment. With the development of various digital means, 3D printing has been widely used in the manufacture of dental prostheses. Implant denture, known as the second set of human teeth, has become a hot spot in clinical practice for its advantages of aesthetic and comfort. At present, oral implants are mainly manufactured by traditional methods. 3D printing can improve the implant personalization and production efficiency. Research shows that 3D printing implants are feasible, but there is no unified conclusion on implant design and surface modification. By introducing the latest research progress of 3D printed metal and all-porcelain implants, this paper aims to bring thoughts on implant material selection, production process, surface design and modification, and provide references for further research on 3D printed implants, so as to better serve the clinical practice.

Key words: dental implant, 3D printing, additive manufacturing, titanium implant, ceramics

中图分类号:

R783.6

王伟娜, 雒静, 赵金花, 李泽彬, 李潇. 三维打印口腔修复种植体的研究进展[J]. 口腔医学, 2024, 44(2): 156-160.

WANG Weina, LUO Jing, ZHAO Jinhua, LI Zebin, LI Xiao. Research progress of dental implant fabricated with 3D printing[J]. Stomatology, 2024, 44(2): 156-160.

参考文献 49

[1]	Barazanchi A, Li KC, Al-Amleh B, et al. Additive technology:Update on current materials and applications in dentistry[J]. J Prosthodont, 2017, 26(2):156-163. doi: 10.1111/jopr.12510 pmid: 27662423
[2]	Wan Hassan WN, Yusoff Y, Mardi NA. Comparison of reconstructed rapid prototyping models produced by 3-dimensional printing and conventional stone models with different degrees of crowding[J]. Am J Orthod Dentofacial Orthop, 2017, 151(1):209-218. doi: 10.1016/j.ajodo.2016.08.019
[3]	Turbush SK, Turkyilmaz I. Accuracy of three different types of stereolithographic surgical guide in implant placement:An in vitro study[J]. J Prosthet Dent, 2012, 108(3):181-188. doi: 10.1016/S0022-3913(12)60145-0
[4]	Chen JY, Zhang ZG, Chen XS, et al. Design and manufacture of customized dental implants by using reverse engineering and selective laser melting technology[J]. J Prosthet Dent, 2014, 112(5):1088-1095.e1. doi: 10.1016/j.prosdent.2014.04.026 pmid: 24939253
[5]	Pirker W, Wiedemann D, Lidauer A, et al. Immediate, single stage, truly anatomic zirconia implant in lower molar replacement:A case report with 2.5 years follow-up[J]. Int J Oral Maxillofac Surg, 2011, 40(2):212-216. doi: 10.1016/j.ijom.2010.08.003
[6]	Ciocca L, Fantini M, de Crescenzio F, et al. Direct metal laser sintering (DMLS) of a customized titanium mesh for prosthetically guided bone regeneration of atrophic maxillary Arches[J]. Med Biol Eng Comput, 2011, 49(11):1347-1352. doi: 10.1007/s11517-011-0813-4 pmid: 21779902
[7]	Figliuzzi M, Mangano F, Mangano C. A novel root analogue dental implant using CT scan and CAD/CAM:Selective laser melting technology[J]. Int J Oral Maxillofac Surg, 2012, 41(7):858-862. doi: 10.1016/j.ijom.2012.01.014
[8]	Mangano FG, de Franco M, Caprioglio A, et al. Immediate, non-submerged, root-analogue direct laser metal sintering (DLMS) implants:A 1-year prospective study on 15 patients[J]. Lasers Med Sci, 2014, 29(4):1321-1328.
[9]	周万琳, 李美华. 选择性激光烧结3D打印钛合金种植体的制备[J]. 哈尔滨医科大学学报, 2019, 53(6):593-597.
[10]	Mangano F, Pozzi-Taubert S, Zecca PA, et al. Immediate restoration of fixed partial prostheses supported by one-piece narrow-diameter selective laser sintering implants:A 2-year prospective study in the posterior jaws of 16 patients[J]. Implant Dent, 2013, 22(4):388-393. doi: 10.1097/ID.0b013e31829afa9d
[11]	Ng SL, Das S, Ting YP, et al. Benefits and biosafety of use of 3D-printing technology for titanium biomedical implants:A pilot study in the rabbit model[J]. Int J Mol Sci, 2021, 22(16):8480. doi: 10.3390/ijms22168480
[12]	le Guéhennec L, Soueidan A, Layrolle P, et al. Surface treatments of titanium dental implants for rapid osseointegration[J]. Dent Mater, 2007, 23(7):844-854. doi: 10.1016/j.dental.2006.06.025 pmid: 16904738
[13]	王蕊, 李美华, 周万琳. 3D打印钛合金种植体的制备及其骨结合性能[J]. 吉林大学学报(医学版), 2021, 47(1):82-88.
[14]	Ren B, Wan Y, Liu C, et al. Improved osseointegration of 3D printed Ti-6Al-4V implant with a hierarchical micro/nano surface topography: An in vitro and in vivo study[J]. Mater Sci Eng C Mater Biol Appl, 2021, 118:111505. doi: 10.1016/j.msec.2020.111505
[15]	Tu CC, Tsai PI, Chen SY, et al. 3D laser-printed porous Ti₆Al₄V dental implants for compromised bone support[J]. J Formos Med Assoc, 2020, 119(1 Pt 3):420-429. doi: 10.1016/j.jfma.2019.07.023
[16]	Olivier V, Faucheux N, Hardouin P. Biomaterial challenges and approaches to stem cell use in bone reconstructive surgery[J]. Drug Discov Today, 2004, 9(18):803-811. doi: 10.1016/S1359-6446(04)03222-2 pmid: 15364068
[17]	Ran QC, Yang WH, Hu Y, et al. Osteogenesis of 3D printed porous Ti₆Al₄V implants with different pore sizes[J]. J Mech Behav Biomed Mater, 2018, 84:1-11. doi: S1751-6161(18)30124-3 pmid: 29709846
[18]	Yang F, Chen C, Zhou QR, et al. Laser beam melting 3D printing of Ti₆Al₄V based porous structured dental implants:Fabrication, biocompatibility analysis and photoelastic study[J]. Sci Rep, 2017, 7:45360. doi: 10.1038/srep45360 pmid: 28350007
[19]	Gao CH, Wang CY, Jin H, et al. Additive manufacturing technique-designed metallic porous implants for clinical application in orthopedics[J]. RSC Adv, 2018, 8(44):25210-25227. doi: 10.1039/C8RA04815K
[20]	Yin S, Zhang WJ, Tang YM, et al. Preservation of alveolar ridge height through mechanical memory:A novel dental implant design[J]. Bioact Mater, 2020, 6(1):75-83.
[21]	Murr LE. Additive manufacturing of biomedical devices:An overview[J]. Mater Technol, 2018, 33(1):57-70. doi: 10.1080/10667857.2017.1389052
[22]	黄硕, 郭芳, 刘宁, 等. 3D打印个性化根形钛合金种植体在下颌磨牙区即刻种植的临床研究[J]. 口腔医学研究, 2021, 37(7):602-606. doi: 10.13701/j.cnki.kqyxyj.2021.07.006
[23]	Dantas TA, Carneiro Neto JP, Alves JL, et al. In silico evaluation of the stress fields on the cortical bone surrounding dental implants:Comparing root-analogue and screwed implants[J]. J Mech Behav Biomed Mater, 2020, 104:103667. doi: 10.1016/j.jmbbm.2020.103667
[24]	Xiong YY, Qian C, Sun J. Fabrication of porous titanium implants by three-dimensional printing and sintering at different temperatures[J]. Dent Mater J, 2012, 31(5):815-820. pmid: 23037845
[25]	Mitra I, Bose S, Dernell WS, et al. 3D Printing in alloy design to improve biocompatibility in metallic implants[J]. Mater Today (Kidlington), 2021, 45:20-34.
[26]	Lee J, Lee JB, Yun J, et al. The impact of surface treatment in 3-dimensional printed implants for early osseointegration:A comparison study of three different surfaces[J]. Sci Rep, 2021, 11(1):10453. doi: 10.1038/s41598-021-89961-3
[27]	Li L, Lee J, Amara HB, et al. Comparison of 3D-printed dental implants with threaded implants for osseointegration:An experimental pilot study[J]. Materials (Basel), 2020, 13(21):4815. doi: 10.3390/ma13214815
[28]	Zhang XT, Mao J, Zhou YF, et al. Mechanical properties and osteoblast proliferation of complex porous dental implants filled with magnesium alloy based on 3D printing[J]. J Biomater Appl, 2021, 35(10):1275-1283. doi: 10.1177/0885328220957902
[29]	Bollman M, Malbrue R, Li CH, et al. Improvement of osseointegration by recruiting stem cells to titanium implants fabricated with 3D printing[J]. Ann N Y Acad Sci, 2020, 1463(1):37-44. doi: 10.1111/nyas.v1463.1
[30]	李伶俐, 王之发, 李潇. 3D打印Ti-6Al-4V多孔支架碱酸热处理并负载黄芩苷涂层的制备及生物学评价[J]. 实用口腔医学杂志, 2020, 36(6):850-854.
[31]	Maher S, Wijenayaka AR, Lima-Marques L, et al. Advancing of additive-manufactured titanium implants with bioinspired micro- to nanotopographies[J]. ACS Biomater Sci Eng, 2021, 7(2):441-450. doi: 10.1021/acsbiomaterials.0c01210 pmid: 33492936
[32]	Mai HN, Lee KB, Lee DH. Fit of interim crowns fabricated using photopolymer-jetting 3D printing[J]. J Prosthet Dent, 2017, 118(2):208-215. doi: 10.1016/j.prosdent.2016.10.030
[33]	倪王成, 胡琳驰, 张维丹, 等. 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.
[34]	贲玥, 张乐, 魏帅, 等. 3D打印陶瓷材料研究进展[J]. 材料导报, 2016, 30(21):109-118.
[35]	Ebert J, Ozkol E, Zeichner A, et al. Direct inkjet printing of dental prostheses made of zirconia[J]. J Dent Res, 2009, 88(7):673-676. doi: 10.1177/0022034509339988 pmid: 19641157
[36]	Rutz AL, Hyland KE, Jakus AE, et al. A multimaterial bioink method for 3D printing tunable, cell-compatible hydrogels[J]. Adv Mater, 2015, 27(9):1607-1614. doi: 10.1002/adma.v27.9
[37]	Derby B. Additivemanufacture of ceramics components by inkjet printing[J]. Engineering, 2015, 1(1):113-123. doi: 10.15302/J-ENG-2015014
[38]	Bertrand P, Bayle F, Combe C, et al. Ceramic components manufacturing by selective laser sintering[J]. Appl Surf Sci, 2007, 254(4):989-992. doi: 10.1016/j.apsusc.2007.08.085
[39]	Yves-Christian H, Jan W, Wilhelm M, et al. Net shaped high performance oxide ceramic parts by selective laser melting[J]. Phys Procedia, 2010, 5:587-594. doi: 10.1016/j.phpro.2010.08.086
[40]	Ratsimba A, Zerrouki A, Tessier-Doyen N, et al. Densification behaviour and three-dimensional printing of Y₂O₃ ceramic powder by selective laser sintering[J]. Ceram Int, 2021, 47(6):7465-7474. doi: 10.1016/j.ceramint.2020.11.087
[41]	Osman RB, van der Veen AJ, Huiberts D, et al. 3D-printing zirconia implants; a dream or a reality? An in-vitro study evaluating the dimensional accuracy, surface topography and mechanical properties of printed zirconia implant and discs[J]. J Mech Behav Biomed Mater, 2017, 75:521-528. doi: 10.1016/j.jmbbm.2017.08.018
[42]	Ioannidis A, Bomze D, Hämmerle CHF, et al. Load-bearing capacity of CAD/CAM 3D-printed zirconia, CAD/CAM milled zirconia, and heat-pressed lithium disilicate ultra-thin occlusal veneers on molars[J]. Dent Mater, 2020, 36(4):e109-e116. doi: 10.1016/j.dental.2020.01.016 pmid: 31992483
[43]	郭亮, 金而立, 苏嘉敏, 等. 氧化锆陶瓷DLP 3D打印技术研究[J]. 应用激光, 2020, 40(6):1040-1044.
[44]	赵祯, 代康, 高勃. 3D打印陶瓷技术在口腔医学领域的研究进展[J]. 中国实用口腔科杂志, 2021, 14(6):739-744.
[45]	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 Method Biomed Eng, 2017, 33(5):e820.
[46]	Kim JC, Yeo ISL. Bone response to conventional titanium implants and new zirconia implants produced by additive manufacturing[J]. Materials (Basel), 2021, 14(16):4405. doi: 10.3390/ma14164405
[47]	Pirker W, Kocher A. Immediate, non-submerged, root-analogue zirconia implants placed into single-rooted extraction sockets:2-year follow-up of a clinical study[J]. Int J Oral Maxillofac Surg, 2009, 38(11):1127-1132. doi: 10.1016/j.ijom.2009.07.008
[48]	Shen ZJ, Liu LF, Xu XQ, et al. Fractography of self-glazed zirconia with improved reliability[J]. J Eur Ceram Soc, 2017, 37(14):4339-4345. doi: 10.1016/j.jeurceramsoc.2017.03.008
[49]	Moin DA, Hassan B, Wismeijer D. A novel approach for custom three-dimensional printing of a zirconia root analogue implant by digital light processing[J]. Clin Oral Implants Res, 2017, 28(6):668-670. doi: 10.1111/clr.2017.28.issue-6