不同表面形貌的纯钛种植体对牙龈软组织界面影响的扫描电镜观察

Observation on attachment of soft tissue on titanium implants with different micro-morphology surfaces by SEM

目的:比较不同的纯钛种植体表面形貌对牙龈软组织界面的影响,寻找一种有利于牙龈软组织附着的种植体颈部表面形貌。方法:采用电化学方法使纯钛金属种植体形成4种表面,即酸蚀组(AE组)纳米表面、电化学腐蚀1和2组(ECE1和ECE2组)的微米表面、电化学腐蚀加酸蚀组(ECA组)的微米-纳米表面,并以光滑组(S组)光滑表面作为对照,将5种试件即刻植于犬下颌骨中,术后20d及3个月分别处死各组犬,制作标本后采用扫描电镜观察牙龈软组织与种植体表面结合界面的情况。结果:各组犬牙龈上皮与种植体表面连接紧密,组间比较未见明显差异;去除软组织后种植体表面未见上皮组织残留。S组胶原纤维平行黏附于种植体表面,与种植体表面大部分开裂分离,去除软组织后种植体表面残留胶原纤维较少;其他各组胶原纤维均垂直扎向种植体表面,牙龈组织面与种植体表面形成复杂的微米-纳米镶嵌结构,与种植体表面开裂较少;ECE2组和ECA组去除软组织后种植体表面残留的胶原纤维多于AE组和ECE1组。结论:通过电化学方法处理得到的微米和微米-纳米表面的种植体可明显改善牙龈软组织与种植体表面的黏附。

Objective To compare the effects of five different titanium surface characteristics of implants on gingival soft tissue interface and to find a proper implant neck surface characteristic for the preferable adhesion of the gingival soft tissue. Methods The titanium implants were processed by electrochemical methods to form four different surfaces, namely the Nano morphology of acid etching group （AE group）, the Micron morphology of electrochemical etching group 1 and 2 （ECE1 group and ECE2 group）, the micro or Nano morphology of electrochemical etching and acid etching group （ECA group）; and the smooth morphology in smooth group （S group） was used as control. These five kinds of implants were immediately implanted in the mandible of 6 experimental dogs in a certain order. The dogs were sacrificed respectively after 20 d and 3 months, and then the specimens were manufactured and scanning electron microscope was used to observe the bonding interface of the gingival with the implant surface. Results The gingival epithelium bonded with the implant surface closely. No significant difference was found among all groups; after removal of soft tissue, there was no epithelial tissue remaining on implant surfaces. The collagen fibers in S group adhered and paralleled with the implant surface, and most of the collagen fibers dehisced and separated from implant surface; and few residual collagen fibers remained on implant surface. The collagen fibers in other groups were vertical to the implant surfaces. The interface of gingival tissue and implant surface formed complex micro-Nano mosaic structures, and the gingival tissue dehisced less from implant surfaces compared with S group; the collagen fibers remaining on the implant surface in ECE2 group and ECA group were more than those in AE group and ECE1 group. Conclusion The micron and micron - nanometer surface can significantly improve the adhesion of the gingival soft tissue on the implant with the methods of electrochemistry.