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种植修复基台穿龈锥度变化对牙龈附着的影响

Impact of implant restorative abutment emergence taper changes on gingival attachment
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摘要 目的通过体内实验检测测试基台穿龈部位不同锥度和材料对种植体周围软组织附着的影响,并选出最佳的基台穿龈锥度。方法用CAD/CAM技术制作出不同穿龈锥度的Ti6Al4V和氧化锆基台,对基台进行表面处理后,植入到动物口腔内,在愈合后四周处死动物,通过HE染色及免疫组织化学染色(immunohistochemistry,IHC)观察牙龈与不同材料和不同锥度基台结合时的组织学反应情况。结果自制的不同穿龈锥度基台表面的粗糙度:Ti6Al4V为Ra=0.16μm,氧化锆为Ra=0.34μm;HE染色:35°组炎症细胞较其他组多,20°~30°组炎症细胞数量及分布无明显差异,氧化锆组较Ti6Al4V组炎症明显;IHC染色:在基台和周围上皮之间的界面观察到层粘连蛋白-5(laminin-5,LN-5)的免疫组化染色强度随着穿龈锥度的增加在30°时达到顶峰;氧化锆组相对Ti6Al4V组呈弱表达;LN-5的定量分析可见20°~40°组的平均光密度(mean optical density,MOD)分别为0.27±0.00、0.29±0.00、0.35±0.00、0.24±0.01、0.25±0.01,各组间对比均有统计学意义;Ti6Al4V和氧化锆的MOD值分别为0.29±0.00、0.20±0.01,有统计学意义。结论组织学反应间接证明30°穿龈锥度的修复基台软组织附着能力较好,3D打印Ti6Al4V基台较数字化切削氧化锆基台软组织附着能力好。 Objective To assess the impact of different tapers and materials of abutments on peri-implant soft tissue attachment in vivo,and to select the best abutment taper.Methods Ti6Al4V and zirconia abutments with different tapers were prepared using CAD/CAM technology.The abutments underwent surface treatment and were placed into the oral cavities of animals.The animals were executed four weeks after healing,and the gingival attachment to abutments with different materials and tapers was observed using HE staining and immunohistochemistry(IHC).Results Roughness Ti6Al4V Ra=0.16μm,zirconia Ra=0.34μm.HE staining showed that there were more inflammatory cells in the 35°group than in the other groups,while there was no significant difference in the number and distribution of inflammatory cells in the 20°~30°groups,and the inflammation in zirconia group was more obvious than that in Ti6Al4V group.IHC staining demonstrated an immune response to laminin-5 at the interface between the abutment and the surrounding epithelium.The expression intensity reached its peak at 30°with the increase of the emergency taper.The expression in the zirconia group was weaker than that in the Ti6Al4V group.The MOD values(Mean Optical Density)of 20°to 40°were 0.27±0.00,0.29±0.00,0.35±0.00,0.24±0.01 and 0.25±0.01,respectively.The MOD values of Ti6Al4V and zirconia were 0.29±0.00 and 0.20±0.01,respectively.Conclusion The soft tissue attachment ability of the restorative abutment with 30°emergency taper was better,and the 3D-printed Ti6Al4V abutment was better than the digitally cut zirconia abutment.
作者 徐欣馨 王心彧 韩泽奎 张亮 高士军 Xu Xinxin;Wang Xinyu;Han Zekui;Zhang Liang;Gao Shijun(School of Stomatology,Jiamusi University,Jiamusi 154007,Heilongjiang,China;Affiliated Stomatological Hospital,Key Laboratory of Oral Biomaterials and Clinical Applications of Heilongjiang Province,Jiamusi University,Jiamusi 154007,Heilongjiang,China)
出处 《中国口腔种植学杂志》 2024年第1期36-41,共6页 Chinese Journal of Oral Implantology
关键词 种植修复基台 穿龈锥度 数字化切削 3D打印 Implant restorative abutment Emergence taper Digital cutting 3D printing
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