牙种植体-基台界面微渗漏的产生及防护机理研究

Intraoral mastication loading forces cast micromotions between the implant-abutment interfaces (IAI). The fretting effect of micromotion leads to the misfit and microgap formations in IAI, resulting in IAI microleakage, which is a verified factor for peri-implantitis and other complications. The 3M rule (micromotion, microgap and microleakage) could has the synergistically aggravation effects for dental material fretting abrasion. The investigation would clarify the mechanism of IAI microleakage through establishing static and kinematic in vitro 3M models under simulated oral environments. The contact mechanics of IAI can be analyzed. The range and three-dimensional form of IAI microgap can be tested under in vitro fretting cyclic loading experiments. The major components of IAI microleakage varied with the loading cycles. Therefore, utilizing human saliva, core microorganism of peri-implantitis, dye agents and other penetration media, the fluctuations would be inspected with the Miseq 16S rDNA analysis technique, inductively coupled plasma mass spectrometry (ICP-MS) and other techniques. Each IAI microleakage major component would be tested with cell cultivation to study its effect on peri-implant mucosa and bone tissues. The influence of compound microleakage infiltrations on the peri-implant cells would be investigated as well to reveal the synergistic effect among the components. Sealing materials were designed to decrease the IAI microleakage. Several materials would be examined with the in vitro models to investigate the protective effect for IAI microleakage and further optimizations would be studied. The aim of this study is to investigate the mechanism of the 3M rule interactions and thus provide clinical guidance for novel dental implant designs, clinical sealing methods and the decrease of IAI microleakage.

牙种植体-基台界面的微动普遍存在，微动损伤累积后界面失吻、形成微间隙，进而产生界面微渗漏，是诱发牙种植体周围炎等并发症不可忽视的原因。本课题采用微动-微间隙-微渗漏“三微”协同增损的新思路，建立静态及动态体外研究模型，接触力学分析界面工况，模拟口腔服役环境下，循环加载牙种植体试样，记录不同循环周次微间隙尺寸的动态范围及三维形态；使用人体唾液、牙种植体周围炎核心微生物及染剂等作为渗入介质，通过高通量测序微生物检验检测技术、电感耦合等离子体质谱技术等标定主要微渗漏成分随服役周期的变化；收集微渗漏溶液，采用生物学等手段研究微渗漏成分对种植体周围软、硬组织的危害及分析其动态交互作用；选择几种密封材料，探索其对种植体-基台界面微渗漏的防护作用。本研究探索的牙种植体-基台界面微动-微间隙-微渗漏“三微”相互作用机理，为牙种植体设计、界面密封策略及微渗漏的临床防护提供了新的思路，具有重大临床意义。

本课题建立了牙种植体-基台界面的微动-微间隙-微渗漏“三微”的体外模型，通过对牙种植体样本进行疲劳加载模拟口内环境条件，发现牙种植体-基台界面的微间隙影响了微渗漏，并确定了咀嚼时牙种植体-基台界面微间隙尺寸和微渗漏的动态变化特征。而后根据微动实验获得主要微渗漏成分样本，发现基台微动损伤部位主要在种植体-基台连接处和基台下部；与前牙行使切割功能时的受力运动相比，咀嚼运动微动损伤程度更大，产生的微动金属磨屑更多。进一步分析了主要微渗漏成分对牙种植体周围软、硬组织的毒力危害，探究了密封胶、基台角度、基台材料等因素对种植体-基台界面微动微渗漏的影响。本课题研究成果不仅初步揭示了牙种植体-基台界面的“三微”相互作用机理，而且可以为牙种植体设计、界面密封策略及微渗漏的临床防护提供了新的思路。项目成果包括：SCI论文7篇，中文核心期刊论文2篇；申请和授权专利10项，转化2项；举办学术会议2次，参加学术会议26次；获得省部级以上奖励4项；培养博士研究生共4人，硕士研究生3人。