烤瓷合金材料生物相容性的研究与进展

Research progress in the biocompatibility of metal ceramic alloys

背景:研究表明,戴用金属烤瓷冠后,牙龈和牙周出现的局部组织不良反应与口腔烤瓷合金修复体的金属元素释放有关。目的:总结分析非贵金属烤瓷合金及贵金属烤瓷合金的生物相容性、细胞毒性、细胞代谢及其在分子水平的研究机制。方法:检索1990-01/2012-01PubMed数据库,万方数据库与金属烤瓷合金材料对细胞正常生理代谢及细胞免疫学影响的相关研究。英文检索词为"dental casting alloys,biocompatibility,cytotoxicity,cytokines",中文检索词为"烤瓷合金,生物相容性,细胞毒性,细胞因子"。排除因研究目的与本文无关及内容重复的研究,共保留其中的39篇归纳总结。结果与结论:临床5种常用的烤瓷合金的细胞毒性大小依次为:镍铬合金、钛合金、钴铬合金、钯基合金、金合金。贵金属烤瓷合金除了拥有优越的机械性能、抗变色和耐腐蚀性能以及优良的加工应用性还有良好的细胞相容性和生物相容性。金合金的遗传毒性性能优于镍铬合金、钛合金和钴铬合金,是具有良好生物学性能的牙科烤瓷合金材料。非贵金属烤瓷合金中Co-Cr-Mo生物安全性最高,Ni-Cr-Be生物安全性最低,而Ni-Cr介于两者之间。贵金属烤瓷合金的金瓷结合力比非贵金属烤瓷合金的金瓷结合力高,不易出现崩瓷现象。金层可利用自身的弹性屈服来缓解界面应力的破坏从而分散聚集的内应力相应地增强金瓷的结合强度。

BACKGROUND： Studies have shown that the incidence of local adverse effects of gingival and periodontal tissues after fixation of metal-ceramic crowns may relate to the release of metallic elements by the metal-ceramic restorations. OBJECTIVE： To analyze and summarize the biocompatibilities, cytotoxicities, cell metabolisms and mechanisms in molecular levels of non-noble metal-ceramic and noble metal-ceramic alloys. METHODS： A search of studies published from January 1990 to January 2012 related to the effects of metal-ceramic alloys on normal physiological metabolism and immunology of cells was performed in PubMed database and Wanfang database using the key words of ＂dental casting alloys, biocompatibility, cytotoxicity, cytokines＂ in English and in Chinese, respectively Articles irrelative to this paper and repetitive studies were excluded. Finally, 39 literatures were chosen to summarize. RESULTS AND CONCLUSION： The cytotoxicities of five metal-ceramic alloys commonly used in clinical practice are in order of nichrome alloy, titanium alloy, cobalt-chromium alloy, palladium-based alloy, gold alloy. Noble metal-ceramic alloys have good mechanical properties, anti-tarnish and corrosion-resistant properties, good processing properties, and good cytocompatibilities and biocompatibilities. The genotoxicity of gold alloy is superior to nichrome alloy, titanium alloy and cobalt-chromium alloy. Gold alloy can be well used in dentistry based on its good biological properties. For non-noble metal-ceramic alloys, Co-Cr-Mo has the highest biosafety, Ni-Cr-Be has the lowest biosafety, and the biosafety of Ni-Cr is between those of Co-Cr-Mo and Ni-Cr-Be. Noble metal-ceramic alloys are not easy to be porcelain fractured based on their better bond strengths of metal-porcelain compared with non-noble metal-ceramic alloys. Gold coatings can disperse the gathered internal stress to strengthen the bond strength of metal-porcelain through relief the interface stress based on their own elastic yield.