Hydroxyapatite and their use as coatings in dental implants: a review.
Hydroxyapatite and their use as coatings in dental implants: a review.
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DOI：
10.1615/critrevbiomedeng.v28.i56.10
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发表时间：
2000
影响因子：
--
通讯作者：
J. Ong;D. Chan
中科院分区：
文献类型：
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作者：
J. Ong;D. Chan
目前，在种植体表面沉积羟基磷灰石(HA)还没有标准的制造指南。虽然动物和体外研究已经报道了使用HA涂层植入物的好处以及溶解的风险，但这些短期研究并未证明HA涂层的溶解会导致植入物的损失。此外，许多体内和临床研究没有包括涂层的化学和结构表征，因此很难在研究之间进行比较。在临床上，对于骨深度超过10 mm、皮质较薄、海绵组织密度较小的上颌骨前、下颌后骨，推荐使用HA涂层螺钉种植体。在上颌后牙或皮质层很薄、密度较低时，推荐使用透明质酸涂层圆柱形种植体。然而，使用HA涂层植入物也存在问题。临床医生需要考虑到与钛种植体相比，HA涂层对细菌的敏感性更高。此外，临床医生还需要考虑涂层-基材界面断裂导致HA涂层失效的可能性。最后，除了手术技巧外，临床研究人员还必须精通HA涂层植入物所需的材料特性、与当前HA涂层相关的问题以及使用的适应症。此外，良好的涂层特性及其对骨形成率和种植体长期成功率的影响、涂层-种植体界面强度以及其他更好的涂层工艺的相关性还需要进一步的研究。
At present, no standard manufacturing guideline exists for depositing hydroxyapatite (HA) on implant surfaces. Although animal and in vitro studies have reported on the benefits of using HA-coated implants as well as the risks of dissolution, these short-term studies did not demonstrate that the dissolution of the HA coating leads to a loss of implants. In addition, many in vivo and clinical studies did not include the chemical and structural characterization of the coatings, and thus comparisons between studies are difficult. In the clinics, the recommendation is that HA-coated screw implants be used for the anterior maxilla and posterior mandible where the bone depth exceeds 10 mm and when the cortical layer is thinner and spongiosia is less dense. In the posterior maxilla or when the cortical layer is very thin with low density, the use of HA-coated cylindrical implants is recommended. However, there are concerns for using HA-coated implants. The clinician needs to take into consideration the enhanced bacterial susceptibility of HA coatings compared with titanium implants. In addition, the clinician needs to consider the possible failure of HA coatings as a result of coating-substrate interfacial fracture. Finally, besides the surgical skills, it is also important that the clinical investigators be well versed with the materials characterization needed for HA-coated implants, the problems associated with the current HA coatings, and the indications for use. In addition, the correlation between well characterized coatings and their effect on bone formation rate and long-term implant success, coating-implant interfacial strength, and alternative superior coating process need to be investigated further.