BIOMECHANICAL FACTORS AFFECTING THE BONE-DENTAL IMPLANT INTERFACE
BIOMECHANICAL FACTORS AFFECTING THE BONE-DENTAL IMPLANT INTERFACE
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DOI：
10.1016/0267-6605(92)90049-y
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发表时间：
1992-01-01
期刊：
影响因子：
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通讯作者：
BRUNSKI J B
中科院分区：
文献类型：
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作者：
BRUNSKI J B
虽然众所周知，牙科植入物可以“工作”-成功的Braenemark“骨整合”植入物是一个很好的例子-植入物也可能失败。面临的挑战是对影响植入物性能的所有方面进行基础科学理解。在设计一个成功的牙科种植体时，主要目标是确保种植体能够支持咬合力并将其长期安全地传递到界面组织。生物力学是这个设计问题的核心。主要议题包括：（1）植入物上咬合力的性质;（2）咬合力如何传递到界面组织;（3）界面组织如何对应力传递条件做出生物反应。对于牙种植体上的咬合力，基本问题是确定在各种修复情况下种植体上的体内载荷分量，例如，对于用作单个牙齿替换或用于加载桥体的多个支撑的种植体。已经取得了重大进展，已经提出了几个理论模型，用于确定牙科种植体之间的支持桥的力的分配。然而，需要做更多的工作来澄清这些模型与现实的匹配程度。界面应力传递和界面生物学代表了更困难的、相互关联的问题。一个问题是，牙科植入物的多种不同形状、尺寸、材料、手术部位和动物模型已经排除了生物学上“有利的”与“不利的”界面应力传递条件的任何普遍接受的规则。虽然许多工程研究已经表明，诸如植入物形状、弹性模量、植入物和骨之间的结合程度等变量，可以影响应力传递条件，尚未解决的问题是是否有任何生物意义，这种差异。最近的研究表明，至少，我们在寻找关于界面力学和生物学之间关系的更详细的假设时，应该考虑基本的骨生理学，例如植入后的伤口愈合加上骨建模和重塑的基本过程。
While is is known that dental implants can "work" - the success of the Braenemark "osseointegrated" implant is a prime example - implants can also fail. The challenge is to develop a basis science understanding of all aspects which contribute to implant performance. In designing a successful dental implant, the main objective is to ensure that the implant can support biting forces and deliver them safely to interfacial tissues over the long term. Biomechanics are central in this design problem. Key topics include: (1) the nature of the biting forces on the implants; (2) how the biting forces are transferred to the interfacial tissues; (3) how the interfacial tissues react, biologically, to stress transfer conditions. For biting forces on dental implants, the basic problem is to determine the in-vivo loading components on implants in various prosthetic situations, e.g. for implants acting as single tooth replacement or a multiple supports for loaded bridgework. Significant progress has been made; several theoretical models have been presented for determining the partitioning of forces among dental implants supporting bridgework. However, more work will be needed to clarify how well these models match reality. Interfacial stress transfer and interfacial biology represent more difficult, interrelated problems. One problem is that the multitude of different shapes, sizes, materials, surgical sites and animal models for dental implants has precluded any generally accepted rules for biologically "favorable" vs "unfavorable" interfacial stress transfer conditions. While many engineering studies have shown that variables such as implant shape, elastic modulus, extent of bonding between implant and bone, etc., can affect the stress transfer conditions, the unresolved question is whether there is any biological significance to such differences. Recent research suggest that, at the very least, our search for a more detailed hypothesis regarding the relationship between interface mechanics and biology should take account of basic bone physiology, e.g. wound healing after implantation plus basic processes of bone modeling and remodeling.