機能下におけるインプラント周囲の神経組織と骨組織の経日的動態

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Today, the use of endosseous implants in dentistry is a well recognized method of treatment. An important prerequisite for the long-term success of endosseous implants is that the implant itself and its surrounding hard and soft tissue maintained loading forces without damage. The aim of this study was to examine the chronological changes of occlusal forces on the distribution of neurofilament protein (NFP) positive nerve fibers in the tissue of peri-implant bone. The bilateral 2nd, 3rd and 4th mandibular premolars and the 1st molars were extracted from nine mongrel dogs. After 4 months of healing, screw-type titanium alloy (Ti-6Al-4V) implants with anode-oxidized layer were inserted in the mandible. Three months after insertion, the implants on the molar site were loaded by occlusal forces, while the premolar site were unloaded. After a further 1 week, 4 weeks, 12 weeks, the dogs were transcardiacally perfused, and the specimens were prepared for the hematoxylin-eosin stain, Ungewitter's silver-nitrate method based on the modification of Powers, and the immunohistochemical NFP-positive stain by the labelled streptavidin biotin method. There sections were examined under light microscopy and histomorphometric analysis was performed. The results obtained in this study were summarized as follows : 1. In the one week loaded site, the implant surface was occupied by either bone marrow or fibrous tissue, and in the four weeks loaded site, a significant increasing in bone tissue was observed. However, the NFP-positive nerve fiber was not found on any surface of loaded or unloaded implant-bone interface. 2. In the region in between the area that 200μm away from the implant surface, there was no significant difference in the bone formation in all periods. However, there was a tendency of much more bone formation in the loaded site than in the unloaded site. Also, in the case of loaded site, many of the NFP-positive nerve were found in this region. From the finding of the increase in nerve distribution and its morphological change into tree-like ramification inside the implant surrounding bone, it suggested that proper occlusal forces may be involved with the mechanoreceptive function. 3. In the region 200μm away from the implant surface, bone formation was observed in both of loaded site and unloaded site, especially at the loaded site. Some of the NFP-positive nerve fibers were observed in bundled style in stead of single fiber style. Totally, the nerve distribution was very similar to that of implant surrounding bone as described above, and there was no difference between the loaded site and unloaded site. 4. Different from osseointegrated type implants, in this study although in the loaded implants, the tree-like ramifications or Ruffini endings in the periodontal ligament could not be recognized. However, the existence of NFP-positive nerve fibers around the loaded implants has indicated the probable formation of mechanoreceptor in the peri-implant bone tissues.
九州歯科学会の論文
2000-12-25

機能下におけるインプラント周囲の神経組織と骨組織の経日的動態

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