不同植入扭矩对种植体骨结合影响的临床初步探究

Study on the effects of different insertion torque values on implant osseointegration

目的利用共振频率分析法观察不同的种植体植入扭矩值对不同时间点种植体稳定性以及骨结合效果的影响。方法根据纳入及排除标准选择牙列缺损成年患者49名,共植入86颗种植体,手术由同一高年资种植科医生操作完成。根据种植体植入就位后的所测最终扭矩值（Itv）进行分组：A低扭矩组,Itv为0~15 N·cm;B中扭矩组,Itv为16~35 N·cm;C高扭矩组,Itv为36~50 N·cm。利用共振频率分析仪分别对种植即刻、术后8周、术后12周的稳定指数（ISQ）进行测量分析,比较组内以及不同组间不同时间点种植体稳定性以及骨结合效果的差异。结果 1各扭矩组内比较,随着时间的延长,所有组ISQ均呈上升趋势,其中低、中扭矩组内各时间点间均有统计学差异,高扭矩组内各时间点间均无统计学差异。2各扭矩组间第8周ISQ值无明显差异,低扭矩组第8周ISQ值增加幅度最大;各扭矩组间第12周ISQ值无明显差异。结论种植体植入8周以内是形成良好的种植体骨结合的关键时期;不同的种植体植入扭矩值对于8周以后的骨结合效果影响差异不显著。

Objective To study the effect of different insertion torque values on implant stability and osseointegration by the means of Resonance Frequency Analysis. Methods 49 patients were chosen randomly according to the following standards,with 86 screws implanted. Furthermore,the same experienced clinician finished all surgeries. All implants were divided into three groups based on the insertion torque values： Group A,Itv 0 ~ 15 N·cm; Group B,Itv 20 ~ 40 N·cm; Group C,Itv 〉40 N·cm. The dental implant stability was measured to evaluate the osteointegration by Resonance frequency analysis when implants were placed immediately and at the time point of 8 weeks and 12 weeks after the surgeries. Results 1ISQ improved as the time extended in all groups. Statistical difference was shown in low and medium group while there＇ s no significant difference in high insertion torque value groups. 2 Low ISQ group showed the most obvious increase during 8 weeks; there was no significant difference among the three groups in 8 week and 12 week.Conclusions The 8-week time point is a critical time for implants healing to develop a high-quality osseointegration. What is more,there was no obvious difference of the osseointegration observed at the 8-week time point when ISQ changed among the groups.