利用動物試驗評估鈦植體與氧化鋯植體誘導之軟組織免疫反應

Abstract

在現今的牙醫學，植牙治療已經被證明為可預期性高且經得起長久時間考驗的治療方式。而其中最常使用的植體材料則是鈦金屬或其合金，目前被認定為治療的首選。但是近年來，隨著材料科技的進步，二氧化鋯漸漸有越來越多被用來取代鈦金屬成為牙科植體的材料，因其與鈦金屬相比，有接近之骨整合能力，但有更好的美觀性。在植體使用長時間後，有可能會發生植體周圍黏膜炎甚至引發植體周圍炎的情形，此類疾病皆與植體周圍的軟組織免疫反應有相當大的關聯性。但現有文獻關於軟組織免疫能力多半僅侷限在鈦金屬，關於二氧化鋯植體的軟組織免疫反應研究甚少。此研究主要以小鼠為實驗動物，在上顎分別置入鈦植體與二氧化鋯植體。於手術一週後，取下植體周圍軟組織，進行免疫染色並使用流式細胞儀分析，探討不同材料之植體周圍軟組織免疫反應之差異。 結果顯示，無論是多型核中性白血球之浸潤量，或是巨噬細胞分化之情形，均顯示在二氧化鋯組別中有抑制發炎反應之結果。因實驗組數及條件之限制，對於此結果應謹慎看待，但此研究仍然顯示二氧化鋯植體在臨床應用上，除了美觀上之巨大優勢之外，更好的生物相容性、較低的發炎反應或許將為牙科植體學帶來更多的臨床解決方案。

In contemporary dentistry, implant therapy has been established as a highly predictable and long-lasting treatment modality. The most commonly used implant materials are titanium and its alloys, which are currently considered the gold standard in treatment. However, recent advancements in material science have led to the increasing use of zirconia as an alternative to titanium for dental implants. Zirconia offers comparable osseointegration capabilities to titanium while providing superior esthetic outcomes. Over time, the occurrence of peri-implant mucositis and peri-implantitis has been observed, conditions that are closely related to the immune response of the peri-implant soft tissue. However, existing literature on soft tissue immune response predominantly focuses on titanium implants, with limited studies addressing the immune response to zirconia implants. This study primarily utilized a murine model, with titanium and zirconia implants placed in the maxilla. One week post-surgery, peri-implant soft tissues were harvested, subjected to immunohistochemical staining, and analyzed using flow cytometry to investigate the differences in immune responses of peri-implant soft tissues associated with different implant materials. The results demonstrated that zirconia implants exhibited a suppressed inflammatory response, as evidenced by reduced infiltration of polymorphonuclear neutrophils and a distinct pattern of macrophage differentiation. Due to the limitations in sample size and experimental conditions, these findings should be interpreted with caution. Nevertheless, this study suggests that zirconia implants, beyond their significant esthetic advantages, may offer better biocompatibility and reduced inflammatory responses, potentially providing new clinical solutions in the field of dental implantology.