氧化锆种植体的表面修饰及其对骨整合的影响

doi:10.7518/gjkq.2025060

Abstract

Abstract:

Zirconia implants are considered as promising alternatives to titanium implants because of their tooth-like color that can simulate the appearance of natural teeth, appropriate mechanical properties, and biocompatibility, which reduce peri-implant inflammatory reactions. However, an untreated zirconia surface is bio-inert, which results in limited osseointegration compared with titanium. Considering that surface characteristics play an essential role in the adsorption of protein, adhesion, proliferation, and differentiation of osteogenesis-related cells, numerous surface modifications are applied to enhance the surface bioactivity of zirconia. In this review, various surface modifications of zirconia implants and their effects on osseointegration were comprehensively summarized. Meanwhile, the advantages and disadvantages of se-veral surface modifications were discussed.

Key words: surface modification, osseointegration, zirconia, dental implant

CLC Number:

R783.1

TrendMD:

Jie Yu,Jinsong Liu. Surface modification of zirconia implants to promote bone integration[J].Int J Stomatol, 2025, 52(3): 281-295.

Figures/Tables 5

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方法		特征	参考文献
喷砂		改善粗糙度，低成本，颗粒污染，造成微裂纹	[18-25]
酸蚀		清除杂质，改变化学成分	[28-37]
喷砂-酸蚀		提高粗糙度，清除杂质	[38-46]
SIE		纳米多孔，可选择性	[47-50]
激光	光纤激光	一种稳定的高能光束，波长短，没有空间波动	[59-62]
	CO₂激光	低频率和小光子能量，表面氧化和易碎边缘	[63-66]
	YAG激光	更短的波长聚焦在更小的光斑上	[67-70]
	飞秒激光	增加表面粗糙度，减少残余元素的存在	[71-76]

方法	特征	参考文献
紫外光处理	增强表面亲水性，降低表面碳含量	[77-84]
自组装	自主过程，易于设置，低成本，良好的细胞反应	[85-87]
生物功能化	将生物分子（蛋白质、酶、肽等）接枝于表面	[88-94]
离子注入	镁涂层改善细胞行为	[95-101]

涂层材料	特征	参考文献
生物玻璃	优异的生物活性和骨导电性	[104-109]
磷酸钙	减轻骨吸收，增加初始骨结合强度	[110-119]
二氧化硅涂层	各向同性微图案，诱导成骨细胞早期排列	[120-121]
纳米结构涂层	提供纳米级的粗糙度，促进整合素聚集，药物递送	[122-127]

表面处理	出版年份	动物模型	种植位置	随访/周	表面粗糙度/μm		平均BIC/%	参考文献
表面处理	出版年份	动物模型	种植位置	随访/周	项目	测量值	平均BIC/%	参考文献
机械加工	2019	大鼠	上颌骨	3	Sa	3.23	58.10	[46]
机械加工	2016	小型猪	上颌骨下颌骨	16 16	Ra	0.18	62.4 66.9	[37]
机械加工粗加工等离子体处理粗等离子体处理	2014	兔	胫骨	4	Ra	0.54 1.98 0.54 1.99	58.26 56.93 70.87 72.27	[132]
机械加工	2012	猪	颅骨	12	—	—	67.1	[17]
机械加工	2010	兔	胫骨	6	—	—	26	[16]
粗加工	2009	兔	股骨/胫骨	3	Ra	1.24	95	[109]
机械加工粗加工	2009	大鼠	股骨	4	Ra	0.13 0.36	46.6 59.4	[133]
机械加工	2008	羊	骨盆	8	—	—	75	[134]
喷砂	2017	小型猪	下颌骨	12	—	—	46	[10]
喷砂	2012	兔	股骨	12	—	—	41.35	[24]
喷砂	2012	小型猪	前颅底	16	Sa	0.3 1.7 3.0	61.4 79.3 48.4	[19]
酸蚀	2017	小型猪	下颌骨	12	—	—	61	[10]
酸蚀	2016	小型猪	上颌骨下颌骨	16 16	Ra	0.59	88.8 92.5	[44]
喷砂-酸蚀	2019	大鼠	上颌骨	3	Sa	351.80	80.39	[46]
喷砂-酸蚀	2016	小型猪	下颌骨	8	Ra	0.25	86.24	[45]
喷砂-酸蚀	2013	大鼠	股骨	4	Ra	0.95	33.5	[44]
SIE	2013	兔	股骨	6	—	—	75.01	[47]
垂直光纤激光水平光纤激光垂直YVO4激光水平YVO4激光	2013	大鼠	胫骨	4	Sa	1.84 1.84 1.44 1.44	64.9 49 39.8 17.5	[60]
YAG激光	2014	大鼠	胫骨	4	Sa	3.33	33.92	[70]
飞秒激光	2014	兔	胫骨	4	—	—	47.5	[53]
飞秒激光	2014	狗	下颌骨	12.8	—	—	未加载57.6 即刻负载65.0	[55]
飞秒激光	2013	狗	下颌骨	12	Sa	8.9	未加载48 即刻负载78	[56]
激光改性	2012	兔	股骨	12	—	—	43.86	[24]
紫外光	2019	大鼠	上颌骨	3	Sa	3.09	50.32	[46]
喷砂酸蚀+紫外光	2019	大鼠	上颌骨	3	Sa	322	85.87	[46]
羟磷灰石涂层（浸渍）羟磷灰石涂层（溅射）	2009	兔	股骨/胫骨	3	—	—	95	[109]
微结构纳米表面改性磷酸钙纳米表面改性磷酸钙	2009	兔	股骨	6	Ra	1.0 1.0 1.0	68.6 64.5 69.7	[47]
RKKP	2002	大鼠	股骨	8.5	Ra	0.37	74	[107]

表面改性	优点	缺点
喷砂	微粗糙度，氧化锆表面均匀、温和的各向异性磨损	颗粒污染，微裂纹与相变
酸蚀	均匀粗糙度，消除杂质	改变化学成分，降低抗弯强度
喷砂-酸蚀	提高粗糙度，消除杂质	不可控性，污染
SIE	表面化学性质保持不变，纳米尺度和微观粗糙度	操作复杂，孔隙直径不受控制
光纤激光	稳定高能光束	波长短，无空间波动
CO₂激光	低频率、小光子能量	表面氧化和边缘脆弱
YAG激光	波长较短	聚焦于较小的光斑
飞秒激光	可以得到具有规则几何形状的微槽，精度高、损伤小	基底损坏，造成氧化锆老化
紫外光处理	将氧化锆表面由疏水性转变为亲水性	改变机械性能和变色
自组装	易于设置，产生革命性新成果的潜力巨大	潜在毒性，生物学效应不明确
生物功能化	接枝生物分子能增强氧化锆的生物活性	生物分子与氧化锆表面的黏附力较弱
离子注入	高纯度、低损伤	基底损坏，表面污染
生物玻璃涂层	可严格控制孔隙率	形成裂纹，界面附着力不足
磷酸钙涂层	与骨头相似的矿物成分	涂层分离
二氧化硅涂层	可得到各向同性的微图案结构	涂层分离，影响表面硅烷密度
纳米结构涂层	可获得纳米级的粗糙度，药物递送	涂层与基底的附着力较弱

Surface modification of zirconia implants to promote bone integration

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