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在代谢受损的系统性疾病患者中植入物周围的骨愈合。

Bone healing around implants placed in subjects with metabolically compromised systemic conditions.

机构信息

Biomaterials Division, NYU College of Dentistry, New York, New York, USA.

Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, Brazil.

出版信息

J Biomed Mater Res B Appl Biomater. 2023 Sep;111(9):1664-1671. doi: 10.1002/jbm.b.35264. Epub 2023 May 15.

Abstract

The aim of this study was to evaluate the bone healing of tight-fit implants placed in the maxilla and mandible of subjects compromised with metabolic syndrome (MS) and type-2 Diabetes Mellitus (T2DM). Eighteen Göttingen minipigs were randomly distributed into three groups: (i) control (normal diet), (ii) MS (cafeteria diet for obesity induction), (iii) T2DM (cafeteria diet for obesity induction + Streptozotocin for T2DM induction). Maxillary and mandibular premolars and molar were extracted. After 8 weeks of healing, implants with progressive small buttress threads were placed, and allowed to integrate for 6 weeks after which the implant/bone blocks were retrieved for histological processing. Qualitative and quantitative histomorphometric analyses (percentage of bone-to-implant contact, %BIC, and bone area fraction occupancy within implant threads, %BAFO) were performed. The bone healing process around the implant occurred predominantly through interfacial remodeling with subsequent bone apposition. Data as a function of systemic condition yielded significantly higher %BIC and %BAFO values for healthy and MS relative to T2DM. Data as a function of maxilla and mandible did not yield significant differences for either %BIC and %BAFO. When considering both factors, healthy and MS subjects had %BIC and %BAFO trend towards higher values in the mandible relative to maxilla, whereas T2DM yielded higher %BIC and %BAFO in the maxilla relative to mandible. All systemic conditions presented comparable levels of %BIC and %BAFO in the maxilla; healthy and MS presented significantly higher %BIC and %BAFO relative to T2DM in the mandible. T2DM presented lower amounts of bone formation around implants relative to MS and healthy. Implants placed in the maxilla and in the mandible showed comparable amounts of bone in proximity to implants.

摘要

本研究旨在评估代谢综合征(MS)和 2 型糖尿病(T2DM)患者下颌和上颌中紧密贴合种植体的骨愈合情况。18 只哥廷根小型猪被随机分为三组:(i)对照组(正常饮食),(ii)MS 组(肥胖诱导的 cafeteria 饮食),(iii)T2DM 组(肥胖诱导的 cafeteria 饮食+链脲佐菌素诱导 T2DM)。上颌和下颌前磨牙和磨牙被拔出。愈合 8 周后,植入带有渐进式小支撑螺纹的种植体,并允许其在植入后 6 周内整合,然后取出种植体/骨块进行组织学处理。进行定性和定量组织形态计量学分析(骨-种植体接触率,%BIC,和种植体螺纹内的骨面积占有率,%BAFO)。植入物周围的骨愈合过程主要通过界面重塑和随后的骨沉积来完成。作为系统条件的函数的数据为健康和 MS 组产生了显著更高的%BIC 和 %BAFO 值,相对于 T2DM 组。作为上颌和下颌的函数的数据,对于%BIC 和 %BAFO 均未产生显著差异。当考虑这两个因素时,健康和 MS 组的下颌骨的%BIC 和 %BAFO 值相对于上颌骨有更高的趋势,而 T2DM 组的上颌骨的%BIC 和 %BAFO 值相对于下颌骨更高。所有的系统性疾病在上颌骨中均表现出可比的%BIC 和 %BAFO 水平;健康和 MS 组相对于 T2DM 组在下颌骨中具有更高的%BIC 和 %BAFO 值。T2DM 组在种植体周围的骨形成量相对低于 MS 和健康组。上颌和下颌植入物的骨量相似。

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