Mechanisms of endosseous integration.
Mechanisms of endosseous integration.
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发表时间：
1998
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通讯作者：
J. Davies
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作者：
J. Davies
尽管临床术语“骨整合”描述了骨内种植体的锚定以承受功能载荷，但它没有提供对这种种植体周围骨愈合机制的深入了解。然而，理解骨内种植体周围骨愈合的顺序被认为是制定种植体表面生物学设计标准的关键。结果和讨论该讨论论文表明，导致接触性成骨（植入物表面的骨生长）的植入物周围骨愈合可以从现象上细分为三个不同的阶段，可以通过实验解决。第一种是骨传导，它依赖于分化的成骨细胞通过临时结缔组织支架迁移到植入物表面。该支架与植入物表面的锚固是植入物表面设计的功能。第二种是从头骨形成，导致矿化的界面基质，相当于天然骨组织中骨水泥线中所见的，沉积在植入物表面上。种植体表面形貌将决定所形成的界面骨是否与种植体结合。第三种组织反应，即骨重建，也将在离散部位产生包括从头骨形成的骨-植入物界面。结论牙种植学的治疗结果将主要取决于种植体表面设计，这些设计在这三种不同的整合机制中优化了生物反应。
UNLABELLED Although the clinical term "osseointegration" describes the anchorage of endosseous implants to withstand functional loading, it provides no insight into the mechanisms of bony healing around such implants. Nevertheless, an understanding of the sequence of bone healing events around endosseous implants is believed to be critical in developing biologic design criteria for implant surfaces. RESULTS AND DISCUSSION This discussion paper shows that peri-implant bone healing, which results in contact osteogenesis (bone growth on the implant surface), can be phenomenologically subdivided into three distinct phases that can be addressed experimentally. The first, osteoconduction, relies on the migration of differentiating osteogenic cells to the implant surface, through a temporary connective tissue scaffold. Anchorage of this scaffold to the implant surface is a function of implant surface design. The second, de novo bone formation, results in a mineralized interfacial matrix, equivalent to that seen in cement lines in natural bone tissue, being laid down on the implant surface. Implant surface topography will determine if the interfacial bone formed is bonded to the implant. A third tissue response, that of bone remodeling, will also, at discrete sites, create a bone-implant interface comprising de novo bone formation. CONCLUSION Treatment outcomes in dental implantology will be critically dependent on implant surface designs that optimize the biologic response during each of these three distinct integration mechanisms.