三维稳定螺纹设计对IV型骨生物力学固定和骨整合的影响。

IF 3.4 3区 医学 Q1 ENGINEERING, MULTIDISCIPLINARY
Nicholas J Iglesias, Vasudev Vivekanand Nayak, Arthur Castellano, Lukasz Witek, Bruno Martins de Souza, Edmara T P Bergamo, Ricky Almada, Blaire V Slavin, Estevam A Bonfante, Paulo G Coelho
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引用次数: 0

摘要

在低密度骨区域,如后上颌骨,实现即刻或早期负荷的适当初级稳定性是具有挑战性的。三维(3D)稳定种植体设计具有锥形体,沿外部螺纹形式的长度连续切割凹槽,螺纹顶部结合弯曲和线性几何表面,与传统支撑螺纹剖面的种植体相比,能够增强早期生物力学和骨整合效果。本研究中使用了市售的支撑螺纹设计(TP)种植体和包含3D稳定修剪螺纹设计(TP 3DS)的实验种植体。在成年羊的髂骨上进行了6例截骨手术(N = 14)。截骨部位随机接受TP或TP 3DS植入物以减少部位偏倚。受试者被允许愈合3周或12周(N = 7只羊/时间点),之后整块收集样本(包括种植体和周围骨骼),种植体进行台式生物力学测试(例如,横向载荷)、组织学/组织形态计量学分析或纳米压痕测试。两种种植体设计均获得高插入扭矩(ITV≥30 N⋅cm)和种植体稳定商(ISQ≥70)值,表明初级稳定性高。定性组织形态学分析显示,与TP组在早期3周愈合时间点相比,TP 3DS组沿螺纹区呈现连续的骨-种植体界面。此外,TP 3DS沿着整个种植体长度的切割槽允许在愈合腔内分布自体骨芯片。12周时的组织学评估显示,两组的编织骨增加,愈合腔隙增多,与膜内样愈合模式一致,没有骨枯死。与传统的TP种植体相比,TP 3DS macrogeometry在基线推出测试期间的平均横向载荷增加了约66% (T = 0周,p = 0.036),并且在种植后3周时显著增加了骨与种植体接触(BIC)值(p = 0.006)。在低密度(IV型)骨模型中,与传统的TP相比,TP 3DS植入物表现出更好的性能,在骨整合的早期阶段,基线横向载荷能力增加,BIC增加。这些研究结果表明,改良后的TP 3DS种植体结构有助于更好的生物力学整合,并可能在骨质量受损的情况下促进更快速和稳定的骨锚定。因此,这种改进对于低骨密度区域种植体的成功和寿命具有重要的临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone.

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread's crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone-implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS's cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density.

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来源期刊
Biomimetics
Biomimetics Biochemistry, Genetics and Molecular Biology-Biotechnology
CiteScore
3.50
自引率
11.10%
发文量
189
审稿时长
11 weeks
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