Publication: Efectos de la administración de hormona de crecimiento en la osteointegración de implantes de titanio recubiertos de hidroxiapatita dopada con silicio. Estudio histomorfométrico en calotas de conejo
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2022-04-25
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Universidad Complutense de Madrid
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Abstract
Introducción: Además de factores osteogénicos, se han investigado distintos materiales de recubrimiento de los implantes para mejorar la osteointegración. Uno de los materiales de recubrimiento más recientemente estudiados es la hidroxiapatita dopada con silicio (SiHA). El proceso de recubrimiento de implantes de titanio con esta biocerámica bioactiva se lleva a cabo mediante un proceso denominado dip coating utilizando la tecnología sol-gel y ha demostrado en estudios in vitro que favorece la proliferación de pre-oblastos. Por este motivo, es especialmente interesante llevar a cabo investigaciones que puedan aprovechar el efecto sinérgico de la GH y la SiHA sobre el hueso para mejorar la osteointegración de los implantes de titanio.Objetivos: Los objetivos del estudio fueron, por un lado, analizar de forma cuantitativa y cualitativa el efecto de la GH sobre el hueso mediante el análisis histomorfométrico e histológico de las muestras de las calotas de los conejos. por otro lado, realizar el análisis cuantitativo y cualitativo del efecto que tiene sobre el hueso la utilización de implantes de titanio recubiertos de hidroxiapatita dopada con silicio (Ti@SiHA) a través del análisis de las muestras desde el punto de vista histomorfométrico e histológico. Conclusiones. 1. El análisis cuantitativo de las muestras obtenidas, en base a estudios histomorfométricos, determinó diferencias estadisticamente en el BIC a favor de los conejos tratados con GH local y sistémica respecto a los conejos que no recibieron GH, mientras que la densidad de área de hueso neoformado no mostró diferencias significativas entre los conejos tratados con GH local y sistémica y los conejos sin tratamiento hormonal. 2. El análisis cualitativo de las muestras a través del estudio histológico, no arrojó grandes diferencias entre los conejos tratados con GH local y sistémica y los conejos a tratar, sin embargo, las trabéculas de hueso neoformado parecen ser más gruesas y más anárquicas en los conejos tratados con la hormona. 3. Los implantes experimentales de Ti@SiHA exhibieron, en el estudio histomorfométrico, un BIC significativamente mayor que los implantes control de Ti6A14V. Sin embargo, no se obtuvieron diferencias significativas en la Densidad de área de hueso neoformado. 4. El análisis histológico no mostró diferencias notorias entre los implantes Ti6A14V y Ti@SIHA, pero las trabéculas de hueso neoformado parecen tener mayor contacto con la superficie de los implantes de Ti@SIHA, llegando a introducirse en el interior de su estructura macroporosa, especialmente en los animales tratados con GH local y sistémica. 5. Se necesitan más estudios que combinen la administración local y sistémica de GH con la utilización de implantes de Ti@SIHA, para analizar en profundidad la respuesta de diferentes huesos y comprobar así el efecto sinérgico la gh y los implantes de Ti@SiHA.
In addition to growth factors, several researches have been carried out with coating materials to improve osseointegration. One of the most recently studied coating material is silicon-substituted hydroxyapatite (SiHA). The process of coating titanium implants with this bioactive bioceramic is carried out through a process called dip coating using so-gel technology and in vitro studies have showed the proliferation of pre-osteoblasts. For this reason, it is especially interesting to carry out a reserch with GH and SiHA to evaluate their possible synergistic effect on bone, to improve the osseointegration of titanium dental implants. Objectives: The objectives of the study were to anlyze quantitatively and qualitatively the effect of GH on bone throgh the histomorphometric and histological analysis of the samples from the rabbit cranial vaults. On the other hand, to carry out the quantitative and qualitative analysis of the effectt that the use of titanium implants coatedwith silicon-substituted hydroxyapatite (Ti@SiHA) has on bone through the analysis of the samples from an histomorphometric and histological point of view. Conclusions: 1. The quantitative analysis of the samples obtained, based on histomorphometric studies, determined statistically significant differences in the BIC for the rabbits treated with local and systemic GH respect to the rabbits treated with local and systemic GH and rabbits without hormonal treatment. 2. The qualitative analysis of the samples, through the histological study did not show great differences between the rabbits treated with local and systemic GH and the untreated rabbits, however, the newly formed bone trabeculae appeared to be thicker and more anarchic in te hormone-treated rabbits. 3. The experimental Ti@SiHA implants exhibited, in the histomorphometric study, a significantly higher BIC than the control Ti6A14V implants. However, nosignificant differences were obtained in the Newly formed bone area density. 4. The histological analysis did not show great differences between the Ti6A14V and Ti@SiHA implants, but the newly formed bone trabeculae seemed to have greater contact with the surface of the Ti@SIHA implants, even inside their macroporous structure, especially in animals treated with local and systemic GH. 5. More studies are needed using local and systemic administration with Ti@SiHA implants, to analyze the response of different bones and thus verify the synergisti effect of GH and Ti@SiHA implants
In addition to growth factors, several researches have been carried out with coating materials to improve osseointegration. One of the most recently studied coating material is silicon-substituted hydroxyapatite (SiHA). The process of coating titanium implants with this bioactive bioceramic is carried out through a process called dip coating using so-gel technology and in vitro studies have showed the proliferation of pre-osteoblasts. For this reason, it is especially interesting to carry out a reserch with GH and SiHA to evaluate their possible synergistic effect on bone, to improve the osseointegration of titanium dental implants. Objectives: The objectives of the study were to anlyze quantitatively and qualitatively the effect of GH on bone throgh the histomorphometric and histological analysis of the samples from the rabbit cranial vaults. On the other hand, to carry out the quantitative and qualitative analysis of the effectt that the use of titanium implants coatedwith silicon-substituted hydroxyapatite (Ti@SiHA) has on bone through the analysis of the samples from an histomorphometric and histological point of view. Conclusions: 1. The quantitative analysis of the samples obtained, based on histomorphometric studies, determined statistically significant differences in the BIC for the rabbits treated with local and systemic GH respect to the rabbits treated with local and systemic GH and rabbits without hormonal treatment. 2. The qualitative analysis of the samples, through the histological study did not show great differences between the rabbits treated with local and systemic GH and the untreated rabbits, however, the newly formed bone trabeculae appeared to be thicker and more anarchic in te hormone-treated rabbits. 3. The experimental Ti@SiHA implants exhibited, in the histomorphometric study, a significantly higher BIC than the control Ti6A14V implants. However, nosignificant differences were obtained in the Newly formed bone area density. 4. The histological analysis did not show great differences between the Ti6A14V and Ti@SiHA implants, but the newly formed bone trabeculae seemed to have greater contact with the surface of the Ti@SIHA implants, even inside their macroporous structure, especially in animals treated with local and systemic GH. 5. More studies are needed using local and systemic administration with Ti@SiHA implants, to analyze the response of different bones and thus verify the synergisti effect of GH and Ti@SiHA implants
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Odontología, Departamento de Especialidades Clínicas Odontológicas, leída el 25-02-20222