不同力值即刻载荷对即刻种植体骨结合的影响

Effects of immediate loadings with different forces on immediate implant-bone ossification

背景:动物实验研究显示,对即刻种植体进行功能性地早期载荷或者即刻载荷,并不影响种植体的预后。目的:分析不同力值即刻载荷对即刻种植体骨结合表面成骨的影响。方法:选用6只成年健康雄性犬,拔除其下颌尖牙和第1磨牙之间的所有牙齿(3颗前磨牙),并在其相应的拔牙窝位点立即植入奥齿泰GSⅡ种植体各1颗,共计36颗。植入种植体后24 h采用自行设计制作的种植体垂直加载仪每犬左侧3颗种植体由前至后分别加载0,10,20 N,对应每犬右侧3颗种植体由前至后分别加载30,40,50 N,每天以1 Hz的频率加载10 min,加载0 d及第4,8,12周后分别使用OSSTELL进行ISQ值测量记录。结果与结论:随着加载力值的增加,血清骨钙素和的表达量呈上升趋势,20 N到达最高值,但到达30 N组时数值呈下降趋势,在50 N组到达最低值。即刻种植后4周各组ISQ值均比种植前有少许下降,其中以加载力值50 N组下降的最多。即刻种植后8周各组ISQ值均有不同程度提升,以20 N组上升程度最大,在即刻种植后12周达到各实验组的峰值。切片中可见植入种植体均能与骨组织发生不同程度结合,各组种植体骨结合界面形成范围与时间成正相关。提示较小力值的载荷对种植体骨结合不会产生影响且有一定的促进作用,但当力值较大(≥20 N)时则会影响种植体骨结合的稳定性。

BACKGROUND： Animal studies showed that functional early load or immediate load on immediate implant did not affect the prognosis of implant. OBJECTIVE： To analyze the effect of immediate loading with different forces on the binding surface of immediate implant bone ossification. METHODS： Six adult healthy male dogs were selected. All teeth （three premolars） between cuspid teeth of lower mandible and the first molar were pulled out. One implant （OSSTEM GSII） was immediately implanted, totally 36 implants. The vertical immediate loading by device was used on the implants at 24 hours after implantation. Grouped by the loading force values： 0, 10, 20 N on the left three implants of each dog from front to back, 30, 40, 50 N on the contralateral three implants of each dog, at a frequency of 1 Hz for 10 minutes every day. The implant stability quotient （ISQ） was tested using resonance frequency measurement instrument （OSSTELL） at 0 day, 4, 8 and 12 weeks. RESULTS AND CONCLUSION： With increased load forces, serum osteocalcin expression increased, and peaked on 20 N, but decreased in 30 N group, and lowest in 50 N group. At 4 weeks after immediate implantation, the ISQ values were slightly less than pre-implantation in each group, especially the 50 N group. At 8 weeks after immediate implantation, ISQ values were increased in each group to different degrees. The increased degree of the 20 N group was maximal. At 12 weeks, a peak value was detected in each experimental group. The implants could bind to bone tissues to different degrees. The range of implant-bone interface formation was positivelyassociated with time. Results indicated that the small force cannot impact implant-bone ossification, but promotes it in a manner, but large force value （≥ 20 N） will affect the stability of the implant-bone ossification.