| Abstract | U zadnjih par desetljeća definicija biokompatibilnosti materijala se mijenjala i odrazilana modifikacije proizvodnje materijala korištenih za izradu dentalnih implantatai
modifikacije kirurških i protetskih tehnika vezanih za izradu kompleksnih implantoprotetskihradova. Stupanj biokompatibilnosti sintetski izrađenih materijala korištenih za nadoknaduizgubljenih zuba i struktura koje ih okružuju oduvijek je bio centar pažnje mnogihgranadentalne medicine koje se bave nadoknadom izgubljenih tkiva. Posebne okolnosti vezaneuznadoknadu zuba dentalnim implantatima ovise o kompleksnosti spoja protetskih komponenti
koje prolaze kroz tranzitornu zonu mekih tkiva te povezuju protetsku komponenturadasimplantatom koji je postavljen u kost. Ta situacija predstavlja kompleksnu seriju kemijski i
mehanički promjenjivih uvjeta implantoprotetskog rada kao jedne cjeline. Rad je baziran na pregledu dostupne znanstvene i stručne literature na engleskomjeziku, izabrane pretraživanjem na PubMedu po ključnim riječima “titan”, “cirkonij-oksid”, “obrada površine titana”, “obrada površine cirkonij-oksida” i “oseointegracija”. Uključeni suradovi objavljeni u zadnjih 15 godina, studije s najmanje 10 pacijenata i studije u trajanjuodnajmanje 12 mjeseci. Prilikom evaluacije uzeti su u obzir sljedeći kriteriji: kontakt kosti i
površine implantata (BIC - bone to implant contact), trodimenzijska prosječna hrapavost
površine (Sa), mikropomičnost, adhezija plaka (površinski biofilm). Pregledom relevantne literature uočljivo je da su implantati građeni od komercijalnočistog titana (CpTi) i titanskih legura još uvijek zlatni standard. Titan ima dobra mehaničkasvojstva, biokompatibilan je i inertan. Međutim, zbog povećanih estetskih zahtjevausuvremenoj dentalnoj protetici sve se više primjenjuje cirkonij-oksidna keramika, posebiceuslučajevima vrlo tankog biotipa gingive. Zagovornici primjene cirkonij-oksidne keramikezaizradu dentalnih implantata ističu biokompatibilnost, jako dobra fizikalna, mehanička svojstvai vrlo nizak afinitet za stvaranje biofilma kao glavni razlog primjene. Cirkonij-oksidnekorodira, ne izaziva alergije, bioinertan je i gladak, što je u kontroli plaka izuzetnovažnosvojstvo. |
| Abstract (english) | During the last couple of decades, the definition of biocompatibility of materials hasevolved, this in reflected in modifications of production of materials used for the manufactureof dental implants and in modifications of surgical and prosthetic techniques relatedtothemanufacture of complex implantoprosthetic restorations. The degree of biocompatibilityofsynthetically produced materials used to replace lost teeth, and the structures surroundingthem, has always been the focus of attention within the branches of dental medicine dealingwith replacement of lost teeth. Special circumstances related to the replacement of teethwithdental implants depend on the complexity of joining prosthetic components, that pass throughthe transitional zone of soft tissues, and connect the prosthetics with the implant placedinthebone. This represents a complex series of chemically and mechanically changing conditionsof implantoprosthetic work as a whole. The paper is based on a review of the available scientific and professional literatureinEnglish, selected by searching on PubMed using the key words “titanium”, “zirconiumoxide”, “titanium surface treatment”, “zirconium oxide surface treatment”, and “osseointegration”. Papers published during the last 15 years, studies with at least 10 patients and studies lastingat least 12 months were included. During the evaluation, the following criteria were takenintoaccount: bone to implant contact (BIC - bone to implant contact), three-dimensional averagesurface roughness (Sa), micromobility, and plaque adhesion (surface biofilm). The review of relevant literature demonstrate that implants made of commerciallypuretitanium (CpTi), and of titanium alloys, are still the gold standard. Titaniumhas goodmechanical properties, it is biocompatible and inert. However, due to the increased aestheticrequirements in modern dental prosthetics, zirconium oxide ceramics are increasinglyused, especially in cases of very thin gingival biotype. Proponents of the use of zirconiumoxideceramics, for the manufacture of identical implants, cite as main reasons for its use:
biocompatibility, very good physical and mechanical properties and a very lowaffinityfor theformation of biofilm. Zirconium oxide does not corrode, does not cause allergies, is bioinert
and smooth, which is an extremely important attribute in plaque control. |
