不同软组织处理方式对支抗微种植钉-骨界面的组织学影响

Histological observation of micro-screws anchorage implant-bone interface with different soft tissue handling methods

背景:目前关于采用切开牙龈和非切开牙龈两种方法植入微种植体的微种植钉-骨界面的组织学差异研究尚未见报道。目的:观察采用不同软组织处理方式时支抗微种植钉骨结合率的差异,检测有无上皮植入的发生。方法:成年雄性杂种犬6只,自攻型微种植钉48枚,选择犬的一侧上下颌骨作为实验组,采用非切开牙龈的方式植入自攻型微螺钉;另一侧为对照组,采用切开牙龈的方式植入,两组均使用镍钛拉簧即刻加载水平力200g。于第12周时处死动物,取微种植钉周围骨块,观察支抗微种植钉与骨界面的骨结合率及是否有牙龈上皮植入。结果与结论:两组微种植钉均形成一定骨结合。实验组微种植钉-骨界面可见较多的纤维结缔组织,对照组骨结合率高于实验组(P<0.01)。两组均未检测到牙龈上皮植入。提示两种软组织处理方式下即刻加载微螺钉均可形成一定骨结合,获得临床稳定性;切开牙龈植入法可较非切开牙龈植入法获得更高的骨结合率,而非切开牙龈植入法操作更简便,两种方法发生植入性上皮性囊肿的可能性均很小。

BACKGROUND：The micro-screw anchorage is a newly used orthodontic anchorage,there are often two ways of the implant procedure：cut the gum and non-cut gum,but there is no report about the histological research of the micro-screw-bone interface in these two ways.OBJECTIVE：To compare the osseointegration rate under two different soft tissue handling methods during implantation and to detect whether there is epithelium implantation.METHODS：Six adult male mongrel dogs were selected,and 48 self-drilling micro-screws were prepared,one side of the upper and lower jaws of dogs was randomly selected as the experimental group,and the other side was selected as the control group;Self-drilling micro-screws were implanted without cutting the gum in the experimental group while the self-drilling micro-screws were implanted after cutting the gum in the control group,both the two groups were loaded by using NiTi-coil springs with 200 g constant force immediately.After 12 weeks,the dogs were euthanized and the bone around the micro-screws was obtained as specimen.Hematoxylin-eosin staining method was used to observe the osseointegration rate and epithelium incidences under the two different soft tissue handling methods.RESULTS AND CONCLUSION：Both the groups obtained different levels of osseointegration.There was more fibrous connective tissue in the micro-screws-bone interface of the experimental group.The osseointegration rate in the control group was significantly higher than that in the experimental group（P 0.01）.Epithelial implantation was not found in both two groups.We conclude that micro-screws can obtain osseointegration and clinical stability with both two different soft tissue handling methods during implantation,but cutting gums implantation can acquire higher osseointegration rate than the implantation without cutting gums,the implantation with no cutting is simple in the procedure,the possibility of epithelial implantation with the two soft tissue handling methods seem to be very small.