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首页> 外文期刊>European Cells & Materials >The implant infection paradox: why do some succeed when others fail? Opinion and discussion paper
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The implant infection paradox: why do some succeed when others fail? Opinion and discussion paper

机译：植入物感染悖论：为什么有些失败而有些成功？意见和讨论文件

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Biomaterial-implants are frequently used to restore function and form of human anatomy. However, the presence of implanted biomaterials dramatically elevates infection risk. Paradoxically, dental-implants placed in a bacteria-laden milieu experience moderate failure-rates, due to infection (0.0-1.1 %), similar to the ones of joint-arthroplasties placed in a near-sterile environment (0.1-1.3 %). Transcutaneous bone-fixation pins breach the immune-barrier of the epidermis, exposing underlying sterile-tissue to an unsterile external environment. In contrast to dental-implants, also placed in a highly unsterile environment, these pins give rise to relatively high infection-associated failure-rates of up to 23.0 %. Herein, we attempt to identify causes as to why dental-implants so often succeed, where others fail. The major part of all implants considered are metal-made, with similar surface-finishes. Material choice was therefore discarded as underlying the paradox. Antimicrobial activity of saliva has also been suggested as a cause for the success of dental-implants, but was discarded because saliva is the implant-site-fluid from which viable bacteria adhere. Crevicular fluid was discarded as it is largely analogous to serum. Instead, we attribute the relative success of dental-implants to (1) ability of oral tissues to heal rapidly in the continuous presence of commensal bacteria and opportunistic pathogens, and (2) tolerance of the oral immune-system. Inability of local tissue to adhere, spread and grow in presence of bacteria and an intolerant immune-system are identified as the likely main causes explaining the susceptibility of other implants to infection-associated failure. In conclusion, it is the authors’ belief that new anti-infection strategies for a wide range of biomaterial-implants may be derived from the relative success of dental-implants.
机译：生物材料植入物经常用于恢复人体解剖结构的功能和形式。但是，植入的生物材料的存在大大提高了感染风险。矛盾的是，由于感染（0.0-1.1％），放置在充满细菌的环境中的牙科植入物的失败率中等（类似于在无菌环境中放置关节假体的比例（0.1-1.3％））。经皮骨固定销破坏了表皮的免疫屏障，使下面的无菌组织暴露于未消毒的外部环境。与同样放置在高度无菌环境中的牙科植入物相比，这些销钉产生的感染相关的失败率相对较高，最高可达23.0％。在本文中，我们尝试确定为什么种植牙如此成功而其他种植失败的原因。所考虑的所有植入物的主要部分都是金属制成的，具有类似的表面处理。因此，物质选择被视为潜在的悖论。唾液的抗菌活性也被认为是牙植入物成功的原因，但由于唾液是存活细菌附着的植入部位流体而被放弃。淘汰了宫颈液，因为它与血清非常相似。相反，我们将牙科植入物的相对成功归因于（1）口腔组织在共生细菌和机会病原体持续存在下快速愈合的能力，以及（2）口腔免疫系统的耐受性。细菌和不耐受的免疫系统导致局部组织无法粘附，扩散和生长，这被认为是解释其他植入物对感染相关衰竭的敏感性的可能主要原因。总而言之，作者相信，广泛的生物材料植入物的新抗感染策略可能源于牙科植入物的相对成功。

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