The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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A review of biocompatibility of zirconia and bioactivity as a zirconia implant: In vivo experiment

지르코니아의 생체적합성과 임플란트로서의 생체활성에 대한 연구: In vivo 실험 문헌 고찰

  • Suh, Da-Won (School of Dentistry, Seoul National University) ;
  • Kim, Young-Kyun (Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital) ;
  • Yi, Yang-Jin (Department of Prosthodontics, Seoul National University Bundang Hospital)
  • 서다원 (서울대학교 치의학대학원) ;
  • 김영균 (분당서울대병원 구강악안면외과) ;
  • 이양진 (분당서울대병원 치과보철과)
  • Received : 2018.09.19
  • Accepted : 2018.11.28
  • Published : 2019.01.31
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Abstract

Increasing demands for esthetic dental treatment, zirconia, which has high mechanical and esthetic properties, had been applied more and more in clinics. Therefore, assessment of biocompatibility of zirconia is necessary. In this article, a review of in vivo studies of zirconia compatibility was performed. In vivo studies showed zirconia had great biocompatibility both on soft and hard tissue. Studies with various animals and patients reported high biocompatibility of zirconia. In terms of bone synthesis and bone adhesion, zirconia showed similar biocompatible properties to titanium. On the other hand, zirconia could be used as implant. For using as an implant, various methods of Hydroxyapatite (HA) coating had been suggested. Since HA coating on titanium implant showed some problems such as low bonding strength and degeneration of HA, HA-zirconia composite, HA-coated zirconia, and HA-zirconia functionally graded material (FGM) or intermediate layer of alumina had been proposed. These methods showed higher bonding strength and biocompatibility.

심미적 치료에 대한 요구가 늘어나면서 높은 강도와 심미성을 갖는 지르코니아의 요구도 증가하고 있다. 이러한 흐름에 비추어 지르코니아의 생체적 합성을 평가하는 것은 중요한 일이다. 이번 논문에서는 지르코니아의 생체적합성에 대한 in vivo 실험에 대한 문헌 연구를 진행하였다. In vivo 실험에서 연조직, 경조직에 대한 지르코니아의 생체적합성을 확인할 수 있었다. 다양한 실험동물 및 환자에서 진행된 연구의 대다수에서 지르코니아의 높은 생체적합성이 보고되었으며, 신생골 합성 및 골부착의 면에서 티타늄과 유사한 성질을 보였다. 한편, 지르코니아는 임플란트로도 활용할 수 있다. 임플란트로 활용하기 위해 HA (hydroxyapatite)를 처리하여 생체활성을 높이는 다양한 방식이 제안되고 있다. 하지만 기존의 티타늄 임플란트에 HA를 코팅하는 방식은 낮은 결합강도 및 HA의 변성으로 인한 문제점이 있었기 때문에 HA-지르코니아 composite, HA-coated 지르코니아, HA-지르코니아 functionally graded material (FGM) 또는 알루미나 개재 HA-지르코니아 등의 새로운 방식이 연구되고 있다. 이러한 방식들은 보다 높은 결합강도를 지니고 있으며, 높은 생체적합성을 보여주고 있다.

Keywords

References

  1. Helmer JD, Driskell TD. Research on bioceramics. Symposium on use of ceramics as surgical implants. Clemson University, Clemson, SC. 1969.
  2. Deany IL. Recent advances in ceramics for dentistry. Crit Rev Oral Biol Med 1996;7:134-43. https://doi.org/10.1177/10454411960070020201
  3. Garvie RC, Urbani C, Kennedy DR, McNeuer JC. Biocompatibility of magnesia-partially stabilized zirconia (Mg-PSZ) ceramics. J Mater Sci 1984;19:3224-8. https://doi.org/10.1007/BF00549808
  4. Hulbert SF, Morrison SJ, Klawitter JJ. Tissue reaction to three ceramics of porous and non-porous structures. J Biomed Mater Res 1972;6:347-74. https://doi.org/10.1002/jbm.820060505
  5. Christel P, Meunier A, Heller M, Torre JP, Peille CN. Mechanical properties and short-term in-vivo evaluation of yttrium-oxide-partially-stabilized zirconia. J Biomed Mater Res 1989;23:45-61. https://doi.org/10.1002/jbm.820230105
  6. Ichikawa Y, Akagawa Y, Nikai H, Tsuru H. Tissue compatibility and stability of a new zirconia ceramic in vivo. J Prosthet Dent 1992;68:322-6. https://doi.org/10.1016/0022-3913(92)90338-B
  7. Bianchi AE, Bosetti M, Dolci G Jr, Sberna MT, Sanfilippo S, Cannas M. In vitro and in vivo follow-up of titanium transmucosal implants with a zirconia collar. J Appl Biomater Biomech 2004;2:143-50.
  8. Degidi M, Artese L, Scarano A, Perrotti V, Gehrke P, Piattelli A. Inflammatory infiltrate, microvessel density, nitric oxide synthase expression, vascular endothelial growth factor expression, and proliferative activity in peri-implant soft tissues around titanium and zirconium oxide healing caps. J Periodontol 2006;77:73-80. https://doi.org/10.1902/jop.2006.77.1.73
  9. Scarano A, Piattelli M, Caputi S, Favero GA, Piattelli A. Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study. J Periodontol 2004;75:292-6. https://doi.org/10.1902/jop.2004.75.2.292
  10. Rimondini L, Cerroni L, Carrassi A, Torricelli P. Bacterial colonization of zirconia ceramic surfaces: an in vitro and in vivo study. Int J Oral Maxillofac Implants 2002;17:793-8.
  11. Scarano A, Di Carlo F, Quaranta M, Piattelli A. Bone response to zirconia ceramic implants: an experimental study in rabbits. J Oral Implantol 2003;29:8-12. https://doi.org/10.1563/1548-1336(2003)029<0008:BRTZCI>2.3.CO;2
  12. Sennerby L, Dasmah A, Larsson B, Iverhed M. Bone tissue responses to surface-modified zirconia implants: A histomorphometric and removal torque study in the rabbit. Clin Implant Dent Relat Res 2005;7:S13-20. https://doi.org/10.1111/j.1708-8208.2005.tb00070.x
  13. Piconi C, Burger W, Richter HG, Cittadini A, Maccauro G, Covacci V, Bruzzese N, Ricci GA, Marmo E. Y-TZP ceramics for artificial joint replacements. Biomaterials 1998;19:1489-94. https://doi.org/10.1016/S0142-9612(98)00064-7
  14. Akagawa Y, Ichikawa Y, Nikai H, Tsuru H. Interface histology of unloaded and early loaded partially stabilized zirconia endosseous implant in initial bone healing. J Prosthet Dent 1993;69:599-604. https://doi.org/10.1016/0022-3913(93)90289-Z
  15. Schultze-Mosgau S, Schliephake H, Radespiel-Troger M, Neukam FW. Osseointegration of endodontic endosseous cones: zirconium oxide vs titanium. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:91-8. https://doi.org/10.1016/S1079-2104(00)80022-0
  16. Warashina H, Sakano S, Kitamura S, Yamauchi KI, Yamaguchi J, Ishiguro N, Hasegawa Y. Biological reaction to alumina, zirconia, titanium and polyethylene particles implanted onto murine calvaria. Biomaterials 2003;24:3655-61. https://doi.org/10.1016/S0142-9612(03)00120-0
  17. MacDonald DE, Betts F, Stranick M, Doty S, Boskey AL. Physicochemical study of plasma-sprayed hydroxyapatitecoated implants in humans. J Biomed Mater Res 2001;54:480-90. https://doi.org/10.1002/1097-4636(20010315)54:4<480::AID-JBM30>3.0.CO;2-T
  18. Kong YM, Kim S, Kim HE, Lee IS. Reinforcement of hydroxyapatite bioceramic by addition of $ZrO_{2}$ coated with $Al_{2}O_{3}$. J Am Ceram Soc 1999;82:2963-8. https://doi.org/10.1111/j.1151-2916.1999.tb02189.x
  19. Kong YM, Kim DH, Kim HE, Heo SJ, Koak JY. Hydroxyapatite-based composite for dental implants: an in vivo removal torque experiment. J Biomed Mater Res 2002;63:714-21. https://doi.org/10.1002/jbm.10392
  20. Alam I, Asahina I, Ohmamiuda K, Enomoto S. Comparative study of biphasic calcium phosphate ceramics impregnated with rhBMP-2 as bone substitutes. J Biomed Mater Res 2001;54:129-38. https://doi.org/10.1002/1097-4636(200101)54:1<129::AID-JBM16>3.0.CO;2-D
  21. Kong YM, Bae CJ, Lee SH, Kim HW, Kim HE. Improvement in biocompatibility of $ZrO_{2}-Al_{2}O_{3}$ nano-composite by addition of HA. Biomaterials 2005;26:509-17. https://doi.org/10.1016/j.biomaterials.2004.02.061
  22. Silva VV, Lameiras FS, Lobato ZI. Biological reactivity of zirconia-hydroxyapatite composites. J Biomed Mater Res 2002;63:583-90. https://doi.org/10.1002/jbm.10308
  23. Torricelli P, Verne E, Brovarone CV, Appendino P, Rustichelli F, Krajewski A, Ravaglioli A, Pierini G, Fini M, Giavaresi G, Giardino R. Biological glass coating on ceramic materials: in vitro evaluation using primary osteoblast cultures from healthy and osteopenic rat bone. Biomaterials 2001;22:2535-43. https://doi.org/10.1016/S0142-9612(00)00444-0
  24. Kim HW, Georgiou G, Knowles JC, Koh YH, Kim HE. Calcium phosphates and glass composite coatings on zirconia for enhanced biocompatibility. Biomaterials 2004;25:4203-13. https://doi.org/10.1016/j.biomaterials.2003.10.094
  25. Guo H, Khor KA, Boey YC, Miao X. Laminated and functionally graded hydroxyapatite/yttria stabilized tetragonal zirconia composites fabricated by spark plasma sintering. Biomaterials 2003;24:667-75. https://doi.org/10.1016/S0142-9612(02)00381-2
  26. Quan R, Yang D, Wu X, Wang H, Miao X, Li W. In vitro and in vivo biocompatibility of graded hydroxyapatite-zirconia composite bioceramic. J Mater Sci Mater Med 2008;19:183-7.
  27. Afzal MAF, Kesarwani P, Reddy KM, Kalmodia S, Basu B, Balani K. Functionally graded hydroxyapatite-alumina-zirconia biocomposite: Synergy of toughness and biocompatibility. Mater Sci Eng C 2012;32:1164-73. https://doi.org/10.1016/j.msec.2012.03.003

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