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Craniomaxillofacial Reconstructive and Corrective Bone Surgery - part 3

Từ khi thành lập cách đây 20 năm, cấy ghép ITI đã được làm bằng titan thương mại thuần túy với một bề mặt TPS trong phần xương neo đậu. Thủ tục lớp phủ này, lần đầu tiên được mô tả bởi Hahn và Palich, 11 đã được giới thiệu trong nha khoa cấy ghép lần đầu tiên với ITI cấy ghép vào năm 1974. | 140 H.-P. Weber D.A. Buser and D. Weingart Figure 15.5 Instruments for hollow cylinder site preparation. plant surface is not only in contact with the bone but also with the mucosa. Since their inception 20 years ago ITI implants have been made of commercially pure titanium with a TPS surface in the bone-anchoring section. This coating procedure first described by Hahn and Palich 11 was introduced in implant dentistry for the first time with ITI implants in 1974. It creates a rough and microporous implant surface with a porosity between 30 and 50 I m Figure 15.6 . The oxide film responsible for the biocompatibility of titanium forms on this sprayed layer. Therefore the biocompatibility of the TPS surface is equivalent to a solid titanium body. Technical details of this procedure and the TPS surface were described by Steinemann.12 Bone sink depth. They are press-fit implants which achieve the required primary stability with the preparation of a precise congruent implant bed. The instruments necessary for bone preparation are in part the same as for the HS implant Figure 15.5 three round burs of increasing diameters predrill trephine mill and a color-coded depth gauge. However tap ratchet and guidance key are not necessary. To insert the implant the insertion device is attached to the implant top in the sterile ampoule. The implant is then removed from the ampoule and placed into the bone cavity until a slight resistance is detectable. Subsequently the inserting device is removed and the implant is tapped to its final position using a special tapping instrument and a mallet. The gentle press-fit after insertion allows for good primary stability in recipient sites with a firm bone structure. ITI Implant Material and Tissue Reactions ITI implants are endosseous implants that are anchored in the bone and penetrate the soft tissue cover. Therefore the im- Figure 15.6 Titanium-plasma-sprayed surface TPS in a close-up view. Direct bone apposition onto TPS surfaces was .