3D打印和CAD/CAM氧化锆种植体骨结合性能的动物实验评价

Animal experimental evaluation of bone-implant contact properties of 3D printed and CAD/CAM zirconia implants

目的比较3D打印和计算机辅助设计与制造(CAD/CAM)氧化锆种植体与纯钛种植体在动物体内的骨结合和成骨效果的差异,评价氧化锆种植体骨结合性能。方法分别将3D打印氧化锆、CAD/CAM种植体和钛种植体各20枚随机植入6只Beagle犬的胫骨内,8周后观察氧化锆种植体的成功率和骨结合能力,并与钛种植体进行比较,观察指标为种植体的成功率、反向扭矩值、骨接触率和种植体周围骨密度。数据采用单因素方差分析(ANOVA)进行比较。结果 3组种植体的成功率均为100%。CAD/CAM氧化锆种植体组的反向转矩值均大于35 N·m;3D打印氧化锆种植体组的反向转矩值均大于35 N·m;钛种植体组中2颗种植体的反向转矩值为20~35 N·m,8颗种植体的反向转矩值大于35 N·m。组织学观察:3D打印氧化锆种植体、CAD/CAM氧化锆种植体和纯钛种植体的不含骨髓腔骨结合率分别为(66.35±6.64)%、(61.32±10.41)%和(58.88±25.10)%,含骨髓腔骨结合率分别为(49.57±5.04)%、(42.21±18.58)%和(38.45±23.27)%,平均骨结合率分别为(58.94±6.31)%、(53.56±8.77)%和(48.31±20.76)%,种植体周围骨密度分别为(60.59±7.31)%、(58.50±6.36)%和(58.18±14.80)%,差异无显著性(P>0.05)。结论氧化锆种植体与纯钛种植体的骨结合能力相当,能形成紧密的直接骨接触,因此氧化锆种植体有望成为口腔种植体的可选材料。

Objective To compare the osseointegration difference of 3 D printed zirconia implants and computer aided design-computer assomated manufacture(CAD/CAM) zirconia implants and pure titanium implants in animals, and to evaluate the osteointegration performance of zirconia implants for zirconia implantation in bones. Methods Six Beagle dogs were selected, and randomly planted 20 3 D printed zirconia implants, 20 CAD/CAM implants and 20 titanium implants in tibias. Success rate and osteointegration performance of zirconia implants were evaluated 8 weeks later. Osseointegration performance was compared with titanium implants. The observational indicators of this study were success rate of the bone implant, reverse torque test, bone-to-implant contact rate, and bone density around the implants. SPSS17.0 software was used for statistical analysis of the data. Results The success rates of the three groups of bone implants were all 100%. The reverse torque values of CAD/CAM zirconia implant group were all greater than 35 N·m;the reverse torque values of zirconia implant group with 3 D printed technology were all greater than 35 N·m;in the titanium implant group, the reverse torque value of two implants was between 20 and 35 N·m, and that of eight implants was greater than 35 N·m. Histological observation found that the rates of bone osseointegration without marrow cavity of 3 D printed zirconia implants, CAD/CAM zirconia implants and pure titanium implants were(66.35±6.64)%,(61.32±10.41)% and(58.88±25.10)% respectively. The rates of bone osseointegration with marrow cavity were(49.57±5.04)%,(42.21±18.58)% and(38.45±23.27)% respectively. The average rate of bone osseointegration was(58.94±6.31)%,(53.56±8.77)% and(48.31±20.76)% respectively. Moreover, the bone density around the implants was(60.59±7.31)%,(58.50±6.36)% and(58.18±14.80)% respectively. There was no significant difference after data analysis(P>0.05). Conclusion Zirconia implants have similar osseointegration ability as pure titanium implants, and can form close direct bone contact. Therefore, zirconia implants may be an optional material for dental implants.