人工植牙已是目前缺牙區贋復重要治療方式之一，而能成功進行後續缺牙贋復，必須植入顎骨之植體，與宿主顎骨產生良好骨整合。骨整合即為宿主細胞與生物相容性材料之間產生緊密之結合。因此，材料本身生物相容性，細胞與材料之交互作用以及宿主相關因素，例如年齡或性別，都是目前探討提高骨整合成功率研究方向。
宿主因素以臨床研究為主，在年齡方面，大量研究證實，基本骨代謝機制會隨著年齡增加而退化。理論上於老年病患植牙成功率應該會減低，但目前臨床研究證據為年老並不會降低植牙成功率。但卻缺乏基礎骨整合機制研究，僅有少數以長骨進行之相關實驗，加入年齡因素之研究更少。文獻搜尋結果，僅有一篇研究以不同年齡病患取出之長骨細胞種植於鈦合金之研究，結果顯示年齡會影響早期鈣化及部分分化機制，但對細胞增生卻無影響。
目前尚未解決問題，第一，臨床與基礎研究結果不相同。第二，植牙是植入顎骨，但以顎骨為主之研究卻相當少，結合年齡因素研究更付之闕如。第三，結合顎骨來源細胞與不同表面處理之研究。
故本研究目的，以顎骨初級培養出之骨母細胞，於不同表面處理之純鈦試片上進行研究。探討不同年齡來源之顎骨骨母細胞在不同表面處理試片上，骨整合過程是否有不一樣的表現。
材料與方法如下：自不同年齡層之病患口腔取出之上顎或下顎骨，嘗試於體外培養出骨母細胞。經鹼性磷酸脢染色確認為骨母細胞後，將細胞種植於不同表面處理之鈦試片。本實驗以目前市佔率最高的噴砂酸蝕，以及實驗室長期開發之微弧陽極氧化為主。試片於表面處理後先行測試其表面粗糙度，以電子顯微鏡觀察表面形態。第3，24小時以免疫螢光染色觀察陪養皿中細胞形態，以電子顯微鏡觀察細胞種植於試片後之細胞形態及貼附性。於第1、3、7、14天以alarmar blue assay測量細胞增生，第3、7、14天以鹼性磷酸脢活性監測細胞分化。於第14天以骨鈣素及骨保護素另行監測細胞分化。
實驗結果顯示，本次實驗所使用之方法，經鹼性磷酸脢染色確認，可成功培養出顎骨骨母細胞。而細胞無論於培養皿，或種植於試片後，於試片上生長之細胞型態並無太大差異。但於第24小時，於微弧陽極氧化表面細胞有較佳之延展度。於細胞增生方面，微弧氧化表現最好，而不同年齡層則無明顯差異。細胞分化方面，於鹼性磷酸脢控制組(培養皿)及骨保護素製造，年輕組表現較佳，呈現統計上差異。其餘分組，不同年齡層並無顯著統計差異。
本實驗結論為年齡增加對於顎骨造骨母細胞於鈦試片上之形態，增生無顯著影響，但對部分分化因子有負面影響。表面粗糙處理確實對增生及分化有益，而微弧陽極氧化表現優於噴砂酸蝕。與部分臨床研究結果相符，但仍須更多之樣本，以得到更正確，更有證據之實驗結果。
最後，本實驗建議，既然自人體顎骨培養骨母細胞已是成熟方法。研究人工植牙細胞與分子機制，應優先考慮以人類顎骨骨母細胞進行實驗。另外，不論是動物實驗，或細胞實驗，應將年齡標註做為讀者參考。

Background: Dental implants are a popular treatment for edentulous patients. The host response and the properties of the implant surface are considered the key factors for the success of osseointegration. Aging is one of the factors affecting the host response and has been considered a risk factor for osseointegration. However, little is known about the effects of aging on the molecular responses of bone cells, especially jawbone osteoblasts, to implant materials with different surface treatments. Our aim was to investigate the influence of different implant surface topographies and different ages on the expression of differentiation/proliferation markers in human jawbone osteoblasts.
Material and methods: Titanium disks with different surface treatments, including sandblasting, acid etching (SLA) and microarc oxidation (MAO), were produced. Surface roughness was evaluated by profilometry, and topography was observed by SEM. Tissue was harvested from a human jawbone and cultured to obtain osteoblasts in vitro, which were then seeded onto titanium disks. The growth of osteoblasts isolated from subjects of different ages on all surfaces was compared. Alkaline phosphatase (ALP) activity was tested to determine cell differentiation on day 3, day 7, and day 14, and alamarBlue assays were used to determine cell proliferation on day 1, day 3, day 7, and day 14. Osteocalcin (OC) and osteoprotegerin (OPG) were measured on day 14. A linear mixed model was used in the data analysis.
Results: Fifteen samples were collected, and osteoblasts from the human jawbone were successfully cultured. For the surface effect, the MAO surface better supported cell proliferation and differentiation. Regarding the effect of age, no difference in cell proliferation was noted among the different ages, but a significant difference was found in the expression of differentiation markers (ALP and OPG).
Conclusions: Appropriate surface treatment is important to the mechanism of osseointegration, and age plays some role in osseointegration.

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