Implant Restoration Of Anterior Upper Teeth With Periapical Lesions And Study Of ECM Sheets Promoting Implant Osseointegration

Periapical lesions mainly have two aspects of impact on implantation : the inflammatory environment and bone defects.In this study,we collected 12 typical cases of periapical lesions in the anterior maxilla with different implant timing and tried to explain relevant influential factors.Meanwhile,to improve implant osseointegration,we constructed rat bone marrow mesenchymal stem cells(r BMSCs)derived extracellular matrix(ECM)sheet-implant complexes,of which the effect was evaluated in vitro and in vivo.These ten case reports included 6 cases of immediate implant(Type ?),3 case of early implant with soft tissue healing(Type ?),1 case of early implant with part of bone healing(Type ?),2 case of delayed implant(Type ?).According to literature reviews,the shape and size of lesion area,the amount of residual soft and hard tissue,the status of adjacent teeth,and the aesthetic expectation of patients should be taken into consideration when choosing applicable implant timing for patients with periapical lesions.In order to improve the success rate of implantation in patients with periapical lesions,we conducted an exploration on accelerating implant osseointegration:biological modified implant surface with ECM sheets.Cytological experiments showed that ECM sheets could promote the adhesion,proliferation and osteogenic differentiation of BMSCs.Moreover,ECM sheets could promote bone healing when implanted into tibial metaphysis in rats,which provided a novel idea for the development of surface modified implants.