The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants.
The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants.
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DOI：
10.3390/biology10010012
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发表时间：
2020-12-28
期刊：
影响因子：
4.2
通讯作者：
Estrada-Martínez A
中科院分区：
文献类型：
--
作者：
Chavarri-Prado D;Brizuela-Velasco A;Álvarez-Arenal Á;Dieguez-Pereira M;Pérez-Pevida E;Viteri-Agustín I;Estrada-Martínez A
骨骼作为脊椎动物的支撑组织，能够使其结构和功能适应其活动过程中产生的载荷所产生的机械需求。这种调节作用也发生在骨折的愈合过程中。本研究的目的是确定动态负荷在多大程度上能够调节钛种植体周围的骨愈合反应。这项研究是在实验兔身上进行的，将牙种植到兔的胫骨上，有两个试验组，一个试验组在愈合期间不进行锻炼，另一个试验组在这个过程中每天在跑步机上跑步。试验结果显示，在加载种植体的组中，种植体的骨结合过程得到了改善。这些结果的重要性在于，它为更好地理解可以调节骨愈合的机制打开了大门，特别是围绕种植体，支持基于效率的种植体加载方案。目的：通过动物模型的实验测试，确定骨的机械载荷对种植体骨结合的稳定性和组织形态计量学变量的影响。材料和方法：新西兰大白兔10只(n=40)，双侧胫骨植入4枚种植体。将兔随机分为两组：A组(试验组)5只，在骨结合期间每天在跑步机上跑步20min；B组(对照组)，另5只按常规饲养。监测变量与种植体的一次和二次稳定性(种植体稳定性商数-ISQ)、垂直骨生长、骨与种植体接触(BIC)、再生骨面积和未成熟基质的百分比有关。结果：试验组种植体垂直骨生长(A组1.26±0.48 mm，B组0.32±0.47 mm，p<；0.001)，ISQ值(A组11.25±6.10ISQ，15.73%；B组5.80±5.97ISQ，7.99%，p=0.006)和BIC值(A组19.37%，B组23.60%，p=0.0058)，差异有统计学意义。对照组未成熟骨基质比例(20.68±9.53)明显高于试验组(15.38±8.84)(P=0.108)。A组再生骨面积为280.50±125.40 mm~2，B组为228.00±141.40 mm~2，但差异无统计学意义(p=0.121)。结论：骨的机械载荷改善了种植体骨结合的稳定性和组织形态计量学变量。
The bone, as a vertebrate support tissue, is capable of adapting its structure and function to the mechanical demands resulting from the loads that are produced during the performance of its activity. This regulatory action also occurs during the healing processes of a fracture. The purpose of this study was to determine to what extent a dynamic load was capable of modulating the bone healing response around a titanium implant. The study was carried out on experimental rabbits, to which dental implants were placed in the tibiae and there were two test groups, one in which they did not undergo exercise during healing period and another that ran daily during this process on a treadmill. The trail results showed an improvement in the osseointegration process of the implant in the group in which it was subjected to load. The importance of these results is that it opens the door to a better understanding of the mechanisms that can modulate bone healing, especially around dental implants, supporting implant loading protocols that are based on efficiency. Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.
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