Race to invade: Understanding soft tissue integration at the transmucosal region of titanium dental implants
Race to invade: Understanding soft tissue integration at the transmucosal region of titanium dental implants
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DOI：
10.1016/j.dental.2021.02.005
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发表时间：
2021-04-17
期刊：
影响因子：
5
通讯作者：
Fournier, Benjamin
中科院分区：
文献类型：
--
作者：
Guo, Tianqi;Gulati, Karan;Fournier, Benjamin
目标。牙种植体系统的成功不仅依赖于骨-种植体界面的骨整合，而且还依赖于经黏膜区域的强大的软组织整合(STI)/粘膜整合。然而，大量研究报道，传统的光滑和生物惰性钛基经黏膜构件的STI质量明显低于天然牙，这可能会影响种植体修复的长期成功。在这篇综述文章中，我们讨论了种植体周围组织的结构和组织学特征；比较居住在粘膜区域的各种细胞的作用，并探讨必须解决的基于材料的挑战，以实现STI的早期建立和长期维持。方法。这篇广泛的综述文章批判性地比较和对比了发表在？钛牙种植体周围软组织整合。结果。组织学特征，包括较差的上皮附着和缺乏直接的胶原-种植体/基台结合，是导致种植体/基台周围STI强度较低的原因。此外，在STI建立和成熟过程中，必须调节基台-粘膜界面的各种细胞功能，以实现早期STI。此外，我们讨论并详细介绍了实现稳健STI的挑战，包括口腔细菌环境的存在，以及材料和腐蚀相关问题。最后，讨论了实现和维持强健STI的研究挑战，并针对提高种植体修复体长期存活的未来方向进行了讨论。的意义。基于其组织学特征，与牙齿牙周附着体相比，目前种植体/基台表面的STI不是最佳的，这使得种植体更容易发生疾病的发生和发展。为了获得稳定
Objectives. The success of a dental implant system not only depends on appropriate osseointegration at the bone-implant interface, but also on robust soft-tissue integration (STI)/muco-integration at the transmucosal region. However, numerous studies have reported that the STI quality of conventional smooth and bio-inert titanium-based transmucosal components is significantly inferior to that of natural teeth, which may compromise the long-term success of implant restorations. In this review article, we discuss the structural and histological characteristics of peri-implant tissues; compare the roles of various cells residing in the transmucosal region and explore the material-based challenges that must be addressed to achieve early establishment and long-term maintenance of STI. Methods. This extensive review article critically compares and contrasts the findings from articles published in the domain of ?soft-tissue integration around Ti dental implants?. Results. Histological characteristics, including poorer epithelial attachment and absence of direct collagen-implant/abutment integration, are responsible for the inferior STI strength around dental implants/abutments. Furthermore, various cellular functions during STI establishment and maturation at the abutment-mucosa interface must be modulated to achieve early STI. Moreover, we discuss and detail the challenges of achieving robust STI, including the presence of oral bacterial milieu, as well as material and corrosion related issues. Finally, research challenges towards achieving and maintaining robust STI are discussed, targeting the future directions to enhance the long-term survival of implant restorations. Significance. Based on its histological characteristics, STI on current implant/abutment surfaces is suboptimal compared to the periodontal attachment found at teeth, making implants potentially more susceptible to disease initiation and progression. To obtain stable