Estudo da osseointegração de implantes de liga Ti30Ta instalados sem estabilidade primária. Influência da associação adesivo fibrínico/ácido tranexâmico e da superfície bioativa
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Data
2016-08-29
Autores
Wada, Cristiane Mayumi [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Quando implantes de titânio são instalados imediatamente após a extração dentária podem ocorrer ancoragem primária diminuída e retardo e/ou deficiência do processo de osseointegração. Isto se dá em razão da ampla interface entre as paredes circundantes do alvéolo e a superfície do implante. Evidências científicas demonstram que a resposta dos biomateriais quando inseridos num organismo vivo não depende apenas da sua composição, mas, sobretudo de sua superfície. Particularmente para os implantes dentários, o uso de ligas, o processo de usinagem e os tratamentos superficiais irão determinar características essenciais no desempenho clínico desses dispositivos. A liga Ti30Ta é altamente biocompatível, apresenta boa combinação de elevada resistência e baixo módulo de elasticidade, demonstrando excelente indicação para uso biomédico. O propósito deste trabalho foi avaliar histomorfometricamente em ratos o reparo ósseo ao redor de implantes de liga Ti30Ta com supertfície bioativa (tratamento hidrotérmico/biomimético) e associados à adesivo fibrínico/ácido tranexâmico. Foram confeccionados 32 implantes de Titânio CP Grau 4 (Grupo A/Ticp) e 32 implantes da liga Ti30Ta (Grupo B/Ti30Ta), os quais foram divididos em grupos com 8 implantes cada: GA1(Ticp), GA2(Ticp/ácido fibrínico/ácido tranexâmico), GA3(Ticp/superfície bioativa), GA4(Ticp/ Superfície Bioativa/Adesivo Fibrínico Ácido Tranexâmico), GB1(Ti30Ta), GB2 (Ti30Ta/ ácido fibrínico/ácido tranexâmico), GB3 (Ti30Ta/ superfície bioativa) e GB4(Ti30Ta/ Superfície Bioativa/Adesivo Fibrínico Ácido Tranexâmico). Os implantes dos Grupos A e B foram identificados, acondicionados individualmente, esterilizados por meio de radiação gama e implantados na tíbia direita de 64 ratos machos, os quais foram eutanasiados aos 60 dias pós-operatórios. As peças foram processadas em MMA (Stevenel’s blue/Alizarin red S) para análise histomorfométrica. Os resultados obtidos mostraram diferenças estatísticas significativas tanto para o percentual de contato osso/implante como para o percentual de área óssea dentro dos limites das roscas entre os grupos, com resultados superiores para liga Ti30Ta e para os grupos que receberam o tratamento bioativo de superfície associado à adesivo fibrínico/ácido tranexâmico tendo um percentual de 96,3%. Concluiu-se que a osseointegração de implantes de liga Ti30Ta instalados sem estabilidade primária foi favorecida pela associação adesivo fibrínico/ácido tranexâmico e superfície bioativa. Comparando-se a superfície de titânio com a superfície de Ti30Ta é possível observar um maior crescimento de apatita no Ti30Ta. A formação de uma camada de óxido de Ta2O5 no Ti30Ta pode ser hidratada em SBF para formar grupos de Ta-OH. Esses grupos induzem a nucleação da apatita e crescem espontaneamente consumindo íons de fosfato e cálcio do SBF.
When implants are installed immediately after tooth extraction it may occur decreased primary anchor and delay and / or deficiency of osseointegration process. This occurs because of the large interface between the surrounding walls of the socket and the surface of the implant. Scientific evidence shows that the response of biomaterials when inserted into a living organism depends not only on its composition, but mainly its surface. Particularly for dental implants, use of alloys, the process of machining and surface treatments will determine the essential clinical performance characteristics of these devices. The Ti-30Ta alloy is highly biocompatible and exhibits good combination of high strength and low modulus of elasticity, demonstrating excellent indication for biomedical use. The purpose of this study was to evaluate histomorphometrically in rats bone healing around Ti-30Ta alloy implants with bioactive surface (hydrothermal / biomimetic treatment) and associated with fibrin glue / tranexamic acid. They were made 32 CP titanium implants Grade 4 (Group A / Ticp) and 32 implants of Ti-30Ta alloy (Group B / Ti-30Ta). These groups (n = 8) were divided into groups: GA1 (Ticp), GA2 (Ticp / fibrin glue / tranexamic acid), GA3 (Ticp / bioactive surface) and GA4 (Ticp / bioactive surface/ fibrin glue /tranexamic acid) and GB1 (Ti-30Ta), GB2 (Ti-30Ta / fibrin glue / tranexamic acid), GB3 (Ti-30Ta bioactive surface) and GB4 (Ti-30Ta /bioactive surface/fibrin glue/tranexamic acid). The implants of Groups A and B were identified, packed individually and sterilized by gamma irradiation and implanted in the right tibia of 64 male rats. The animals were euthanized at 60 days postoperatively. The pieces were processed in MMA (Stevenel's blue / red Alizarin S) for histomorphometric analysis. The results showed statistically significant differences to both the contact percentage of bone / implant to bone as percentage area within the confines of the threads between the groups. Thus, superior results were observed for Ti-30Ta alloy and the groups that received the bioactive surface treatment associated with fibrin glue / tranexamic acid. It was concluded that the osseointegration of Ti-30Ta alloy implants installed without primary stability was favored by fibrin adhesive association / tranexamic acid and bioactive surface. Titanium surface comparing with Ti30Ta surface can be seen further growth of apatite in Ti30Ta. The formation of an oxide Ta2O5 layer in Ti30Ta can be hydrated in SBF to form Ta-OH groups. These groups induce the nucleation of apatite and grow spontaneously consuming phosphate and calcium ions from the SBF.
When implants are installed immediately after tooth extraction it may occur decreased primary anchor and delay and / or deficiency of osseointegration process. This occurs because of the large interface between the surrounding walls of the socket and the surface of the implant. Scientific evidence shows that the response of biomaterials when inserted into a living organism depends not only on its composition, but mainly its surface. Particularly for dental implants, use of alloys, the process of machining and surface treatments will determine the essential clinical performance characteristics of these devices. The Ti-30Ta alloy is highly biocompatible and exhibits good combination of high strength and low modulus of elasticity, demonstrating excellent indication for biomedical use. The purpose of this study was to evaluate histomorphometrically in rats bone healing around Ti-30Ta alloy implants with bioactive surface (hydrothermal / biomimetic treatment) and associated with fibrin glue / tranexamic acid. They were made 32 CP titanium implants Grade 4 (Group A / Ticp) and 32 implants of Ti-30Ta alloy (Group B / Ti-30Ta). These groups (n = 8) were divided into groups: GA1 (Ticp), GA2 (Ticp / fibrin glue / tranexamic acid), GA3 (Ticp / bioactive surface) and GA4 (Ticp / bioactive surface/ fibrin glue /tranexamic acid) and GB1 (Ti-30Ta), GB2 (Ti-30Ta / fibrin glue / tranexamic acid), GB3 (Ti-30Ta bioactive surface) and GB4 (Ti-30Ta /bioactive surface/fibrin glue/tranexamic acid). The implants of Groups A and B were identified, packed individually and sterilized by gamma irradiation and implanted in the right tibia of 64 male rats. The animals were euthanized at 60 days postoperatively. The pieces were processed in MMA (Stevenel's blue / red Alizarin S) for histomorphometric analysis. The results showed statistically significant differences to both the contact percentage of bone / implant to bone as percentage area within the confines of the threads between the groups. Thus, superior results were observed for Ti-30Ta alloy and the groups that received the bioactive surface treatment associated with fibrin glue / tranexamic acid. It was concluded that the osseointegration of Ti-30Ta alloy implants installed without primary stability was favored by fibrin adhesive association / tranexamic acid and bioactive surface. Titanium surface comparing with Ti30Ta surface can be seen further growth of apatite in Ti30Ta. The formation of an oxide Ta2O5 layer in Ti30Ta can be hydrated in SBF to form Ta-OH groups. These groups induce the nucleation of apatite and grow spontaneously consuming phosphate and calcium ions from the SBF.
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Palavras-chave
Implantes dentários, Osseointegração, Propriedades de superfície, Adesivo tecidual de fibrina, Ácido tranexâmico