不同抗菌涂层对种植体周围炎骨吸收影响的动物研究

Animal experimental study on effect of different antibacterial coatings on absorption of peri-implant inflammation

摘要:

目的 通过动物体内实验评估钛种植体表面不同的抗菌涂层对种植体周围炎的影响。方法 30 枚 纯钛棒随机分为3 组并进行相应处理：银电沉积处理（Ti-Ag），硅烷化处理（Ti-Si），未进行处理（Ti）。将30 颗种植体随机植入5 只比格犬下颌前磨牙区（每只6 颗种植体），并进行种植体颈部结扎并引入牙周致病菌， 诱导实验性种植体周围炎。种植体周围炎诱导2 个月后，对比格犬进行临床和影像学检查，包括临床指标检 测（菌斑指数、改良龈沟出血指数、探诊深度、牙龈指数、种植体松动度）、X 射线检查、组织学分析，并进行 定量分析。结果 种植体周围炎诱导2 个月后，Ti-Ag 和Ti-Si 组种植体周围黏膜有轻到中度水肿，叩诊声音 清脆，无松动；Ti 组种植体周围黏膜明显水肿，甚至出现破溃、脓液溢出，叩诊声音浑浊，个别种植体临床可 见松动。Ti-Ag 和Ti-Si 组各临床检查指标优于对照组，差异有统计学意义（P <0.05），而Ti-Ag 和Ti-Si 组 各检验指标差异无统计学意义（P >0.05）。X 射线结果显示，Ti-Ag 和Ti-Si 组种植体周围骨无吸收，骨密度均 匀致密；对照组周围牙槽骨呈垂直吸收，种植体与骨组织间可见透射状影像，其骨吸收量小于Ti-Ag 和Ti-Si 组， 差异有统计学意义（P <0.05）。组织学染色见Ti-Ag 和Ti-Si 组较对照组具有更好的骨结合，骨- 种植体接触 率小于对照组（P <0.05）。结论 Ti-Ag 和Ti-Si 抗菌涂层表面处理可以减少种植体周围炎引起的骨吸收。

Abstract:

Objective To investigate the anti-inflammatory effect of different antibacterial material coated on dental implants in animal model of peri-implant inflammation. Methods A total of 30 titanium rods were randomly divided into 3 groups based on material coated on the rod surface: silver electrodeposition (Ti-Ag group), silanization treatment (Ti-Si group) and non-coated rods (control group). Six dental implants were inserted in the mandibular premolar sites of beagle dog (n = 5). Peri-implantitis was initiated by ligation at neck of the implant for 2 months. Identification of peri-implantitis was achieved by plaque index, modified sulcus bleeding index, probing depth, gingival index, mobility of implant, X-ray examination and histological analysis. Results Control group showed mucosa with severe edema (even ulcer or fester), dull percussion and implant loosening, which were significantly alleviated in both Ti-Ag and Ti-Si group. Clinical indexes mentioned above suggested that animals in Ti-Ag and Ti-Si group experienced better recovery when compared with control group. No obvious dramatic difference was founded between Ti-Ag group and Ti-Si group (P > 0.05). X-ray showed no obvious bone resorption around implants in both Ti-Ag and Ti-Si groups while dogs in control group showed obvious vertical absorption of alveolar bone around implant indicated by obvious transmission between bone and implants. Histological staining indicated significantly improved osseointegration in Ti-Ag and Ti-Si groups compared with control group (P < 0.05). Conclusion Antibacterial Ti-Ag and Ti-Si coated rods reduce local inflammation and bone resorption in peri-implantitis.