不同植入术式对老年微创种植牙初期稳定性的影响

Surgical implantation effects on the primary stability of implant in the elderly of minimally Invasive dental implant surgery

目的:利用初始植入扭矩法和间断共振频率分析(resonance frequency analysis,RFA)法检测不同外科术式对老年微创种植牙初期稳定性的影响。方法:选择63名老年上颌前磨牙区后天性牙缺失患者,随机分为常规备洞组,级差备洞组和骨挤压组,在种植术后即刻记录87枚种植体旋入扭矩值和种植体稳定系数)(ISQ)值,术后1、2、4、6、8、12W分别记录各组ISQ值。采用单因素方差分析和LSD-t检验分别进行组间、组内比较扭力值和ISQ值统计学差异。结果:在种植术后记录级差备洞组旋入扭矩平均值为:33.28±3.95 N·CM,明显高于常规备洞组扭矩值(P<0.05);术后即刻测量ISQ平均值,和常规备洞组比较,级差备洞组和骨挤压组ISQ值增加明显,术后呈现下降趋势,至4W时下降至最低值,自术后4W到12W时三组ISQ值上升均比较明显,至术后12W时三组ISQ平均值两两比较无统计学差异(P>0.05)。结论:级差备洞和骨挤压技术能够明显提高在老年人Ⅲ类骨上微创非翻瓣植入人工种植体的初期稳定性。

Objective：To evaluate the primary stability of the implants so as to assess values of the torque and resonance frequency analysis （RFA） of implants by different surgical procedures in the elderly of minimally Invasive dental implant surgery.Methods：87 Implants were placed in 63 elderly patients of missing teeth in maxillary premolar areas and were randomly divided into traditional implanting group, differential backup group and bone extrusion hole group, detected immediately torque values and implant stability quotient （ISQ） value, and deal with ISQ values of each group after implanting surgery in time point of 1,2,4,6,8,12 W. Compared with values of torque value and ISQ statistically between the groups by Using one-way ANOVA and LSD-t test. Results： Average torque values immediately after implantation in backup group is 33.28±3.95 N·CM, significantly higher than the traditional preparation holes torque value （P〈0.05）;mean value of ISQ immediate after operative measurements in groups of backup and bone hole extrusion were higher than that of traditional equipment hole group;the ISQ values showed a downward trend and got the minimized value in time point of 4 W after operation , and then the value of ISQ gradual recovered in 12 W after operation in groups of backup and bone hole extrusion, there was no statistical difference of the values of ISQ after the time point of 12W between 3 groups （P〉0.05）. Conclusion： Surgical technology by means of backup hole and bone extrusion could significantly improve implant primary stability in elderly by means of minimally Invasive dental implant surgery as compared with the traditional hole prepared surgery.