低强度脉冲超声促进牙种植体骨结合的研究进展  

Research progress on low-intensity pulsed ultrasound in promoting osseointegration of dental implants

作　　者：张昕宇 瞿方 胥春 ZHANG Xinyu;QU Fang;XU Chun(Department of Prosthodontics,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔修复科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《口腔疾病防治》2025年第5期417-424,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82071157);上海交通大学医学院附属第九人民医院原创探索项目(JYYC002)。

摘　　要：如何有效促进牙种植体骨结合是临床亟待解决的问题。低强度脉冲超声(low-intensity pulsed ultra-sound,LIPUS)在促进骨组织在内的组织愈合中显露了优异的效果,近年来,其在促进口腔种植体骨结合方面也有较多研究。动物实验结果显示LIPUS展现出了显著的促进种植体骨结合能力。体外实验结果显示LIPUS可通过加强成骨关键因子表达、胞外基质的矿化、诱导局部神经元分泌降钙素基因相关肽(α-calcitonin gene-related peptide,αCGRP)等机制,并通过调控骨形态发生蛋白/Smad蛋白(bone morphogenetic protein/Smad,BMP/Smad)、丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)、磷脂酰肌醇3激酶/蛋白激酶B(phospha-tidylinositol 3-kinase/protein kinase B,PI3k/Akt)通路等来增强骨形成细胞的增殖、迁移和成骨分化等生物学过程,从而促进种植体骨结合。同时也有临床研究显示,LIPUS治疗后种植体周围骨量均有所增加,且颊侧骨板的生长比腭侧更明显。目前尚未有研究系统性地总结LIPUS在促进种植体骨结合中的临床研究证据、体内体外研究和作用机制。因此本综述旨在讨论LIPUS对种植体骨结合的作用机制,进一步提高种植义齿修复治疗的效果。How to effectively promote osseointegration of dental implants remains a pressing clinical challenge.Lowintensity pulsed ultrasound(LIPUS)has demonstrated remarkable efficacy in accelerating the healing of various bodily tissues,including bone tissue.In recent years,there has been extensive research on its application in promoting osseointegration in the field of dental implantology.Animal studies have shown that LIPUS exhibits significant potential in facilitating osseointegration of dental implants.In vitro experiments have further revealed that LIPUS can enhance the expression of key osteogenic factors,extracellular matrix mineralization,and induce local neurons to secreteαCGRP.Through the regulation of signaling pathways such as bone morphogenetic protein/Smad(Bmp/Smad),mitogen-activated protein kinase(MAPK),and phosphatidylinositol 3-kinase/protein kinase B(PI3k/Akt),LIPUS promotes the proliferation,migration,and osteogenic differentiation of osteogenic-related cells,thereby enhancing osseointegration of dental implants.Additionally,clinical studies have shown that bone mass increases around the implants after LIPUS treatment,with more pronounced growth observed on the buccal bone plate than on the palatal side.Furthermore,there is a lack of research that systematically summarizes the clinical evidence,in vitro and in vivo studies,and mechanisms of action regarding the role of LIPUS in promoting osseointegration of implants.Therefore,the aim of this study is to discuss the mechanisms of effect of LIPUS on osseointegration of implants,with the goal of further enhancing the outcome of implant-supported prosthodontic treatment.

关 键 词：低强度脉冲超声 牙种植体 骨结合 骨髓间充质干细胞 骨形成 骨质疏松症 降钙素基因相关肽 丝裂原活化蛋白激酶 

分 类 号：R78[医药卫生—口腔医学]