骨质疏松患者牙种植体的骨整合

M. H. Hammouri, Karina M. Salekh
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引用次数: 0

摘要

颌骨组织修复手术和医学方法的成功应用已在临床实践中得到令人信服的证实。与此同时,正在开发技术来改善骨质疏松症患者种植牙的骨整合。各种种植体涂层的使用以及全身治疗表明,在治疗部分或完全继发性缺牙症伴骨质疏松症患者方面出现了新的方向。这一趋势与现代医学有关。信息来自PubMed数据库,使用关键词“骨质疏松症”和“骨整合”,以及2016年至2022年的“牙科植入”和“唑来膦酸”。文章是根据实验工作挑选的。大量研究表明,骨组织是骨质疏松变化的有效指标。强调了骨质疏松症中骨组织的主要变化——骨体积的减少、骨小梁的微结构和阻止骨整合的过程的恶化——骨量的损失、植入骨复合体中接触百分比的显著降低。已经确定了处理对牙种植术的负面影响的方法。在一项关于双磷酸盐药物全身给药的研究综述中,发现种植牙的骨整合增加,唑来膦酸制剂的全身给药显著增加了新骨的形成,这反过来又有助于消除骨质疏松症的负面影响,如骨吸收。除了系统给药双磷酸盐外,实验研究还描述了以各种植入物涂层形式局部应用双磷酸盐。局部应用双磷酸盐也有助于增加骨整合。与未涂层植入物相比,微结构涂层植入物显示出较少的边缘骨损失。结论使用具有改良宏观和微观浮雕的牙科植入物,以及全身药物治疗,仍然是科学研究的主要方向,有助于优化牙科植入物的骨整合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dental implants osseointegration in patients with osteoporosis
The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.
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