Biomaterialien und Oberflächen- beschichtungen von Implantaten zur Verbesserung der Implantat- Knochen-Interaktion

Zusammenfassung

Seit mehreren Jahrzehnten werden metallische und keramische Implantate in den menschlichen Knochen eingebracht, um dort bestimmte Aufgaben und Funktionen dauerhaft zu erfüllen. Sie sollen über mehrere Jahre oder Jahrzehnte im menschlichen Organismus als Gellenkersatz oder Zahnersatz dienen. Um ihre Funktion zu erfüllen, müssen sie vom Körper angenommen und in den Knochen eingebaut werden. Diesen Vorgang nennt man Osseointegration. Das bedeutet, dass sich zwischen dem Knochen und der Implantatoberfläche ein fester Verbund ausbildet. Demzufolge sind bestimmte Voraussetzungen an das jeweilige Implantat, wie Biokompatibilität und mechanische Festigkeit gestellt. Der Kurz- und Langzeiterfolg von Implantaten ist abhängig von der Stabilität der Implantatverankerung im Knochengewebe. Da die Oberfläche eines Implantats in Kontakt mit dem umliegenden Gewebe steht, spielen Oberflächeneigenschaften wie z. B. chemische Zusammensetzung, Topografie, Rauigkeit, Porosität oder Oberflächenenergie eine entscheidende Rolle. Über die vergangenen Jahrzehnte wurde auf diesen Gebieten viel wissenschaftlicher Aufwand betrieben, um die Osseointegration von Implantaten zu beschleunigen und zu verbessern. Die neuesten Entwicklungen beinhalten bioaktive Oberflächenbearbeitung, die Verwendung von extrazellulären Matrixmolekülen und Wachstumsproteine wie z. B. BMPs, die auf die Implantatoberfläche aufgebracht werden. Ein Teil der neuen Methoden befindet sich in der klinischen Erprobung und ein Teil wird bereits sehr erfolgreich in der klinischen Routine der Endoprothetik eingesetzt.

Summary

For several decades, metallic and ceramic implants are used in human bones to meet there specific tasks and functions as joint replacements or teeth. They are intended to survive in the human body for several years or even decades. In order to perform their function they need to be accepted by the body and incorporated into the bone. This process is called osseointegration. This means forming a firm bond between the bone and the implant surface. Consequently, certain conditions are required by the used implant like biocompatibility and mechanical strength. The short and long term outcome of implants depends on the stability of the implant anchorage in the bone tissue. Since the surface of an implant is in contact with the surrounding enviroment, surface properties such as chemical composition, roughness, porosity, surface energy play a decisive role. Over the past few decades much scientific effort has been made in these areas, to promote and improve the osseointegration of implants. Recent developments include bioactive surface treatment, the use of extracellular matrix molecules, and growth factors such as BMPs, which are incorporated in the implant surface. Partly, the new developments of surface treatments are in clinical trials and some are already very successfully used in clinical routine in joint replacement.

Schlüsselwörter

Implantat-Knochen-Interaktion - Biomaterialien - Oberflächenbeschichtungen - Osseointegration

Keywords

Implantat-bone interaction - biomaterials - surface of an implant - osseointegration

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