不同备洞方法收集自体骨骨量

Study on bone volume harvested from the implant sites with different methods

目的:探讨采用不同方法及不同的种植系统备洞留取自体骨骨量的差异。方法:在均质环氧树脂仿制的下颌骨模型上,应用美国Bicon种植系统、德国Bego种植系统Semados系列或瑞士Straumann种植系统,分别采用全程无水低速备洞或高转速有冷却水备洞再低转速关水出洞(简称开水进关水出钻)的备洞方法,比较同一种植系统用这两种方法留取自体骨骨量的差异,比较不同种植系统用相同方法留取骨骨量的差异,并将其与取骨钻取骨量比较。每一直径钻用一种方法备10个窝洞,留取的骨屑用电子精密天平称重。结果:制备相同洞型时,不论是Bicon还是Bego种植系统全程无水低速备洞法留取的骨量均大于开水进关水出钻方法留取的骨量,差异有统计学意义(P<0.05),前者约是后者的3.3~7.0倍。制备相似洞型时,采用开水进关水出钻的备洞方法,不同种植系统(Bicon、Bego和Straumann)收集骨量差异无统计学意义。Bicon系统无水预备5 mm×10 mm洞型和Bego系统无水预备4.7 mm×10 mm洞型时留取的骨量显著少于取骨钻预备5 mm×10 mm洞型留取的骨量。结论:全程无水低速备洞方法较开水进关水出钻的备洞方法可收集更多自体骨,不同种植系统采用同一方法制备相似洞形时,收集的自体骨骨量无明显差异。

Objective:To compare the volume of autogenous bone particles harvested utilizing different techniques and various implant systems during implant surgery,and to determine the advantageous method to collect autogenous bone particles.Methods:Homogeneous epoxy resin simulated jaw bone model was enrolled.Bicon,Bego implant systems and Straumann tissue level implant systems were utilized.The two techniques were investigated.One method was low-speed drilling(50 r/min)without water irri-gating,and the other one was drilling with cold water irrigating to the ideal depth,then closing the water and drilling out with low speed(50 r/min).The bone particles in the drill groove and implant beds were collected.The volumes of the bone harvested were compared between the different techniques and also among the three implant systems,then they were compared with the volume of the bone harvested by the special bone drill.The sample size of each sub-group was 10.The bone particles were weighed by electronic balance after drying.Results:The harvested bone volume between the latch reamers and hand reamers of Bicon system with the first method was not significantly different.When the same size implant bed was prepared,the volume of the bone particles produced during the implant surgery with low-speed drill without water was significantly higher than that with the other method no matter Bicon[3.5 mm×10 mm hole for example(28.42±6.04)mg vs.(6.30±2.51)mg,P<0.001]or Bego system[2.8 mm×10 mm hole for example(28.95±5.39)mg vs.(4.61±3.39)mg,P<0.001]was used,and the ratio of bone volume between the first method and the second one was approximately 3.3 to 7.0 times.When using the second method to prepare the similar size implant bed,the bone volume was not significant different among Bicon,Bego and Straumann implant systems[Bicon(9.90±3.42)mg,Bego(8.70±4.09)mg,and Straumann(10.56±5.66)mg,P=0.69].When preparing a 5mm-diameter-10mm-length hole with Bicon implant system and a 4.7mm-diameter-10mm-length with Bego implant system,the bone quantity harvested from each group was less than that harvested by special bone drill from Neo Biotech[Bicon(82.54±12.26)mg,Bego(85.07±12.64)mg vs.Neo Biotech(96.78±13.19)mg,P<0.05].Conclusion:More autogenous bone can be harvested from implant beds by preparing with low-speed rolling without water than the method with water irrigation.When utilizing the same preparing method,the implant system has no impact on the volume of the bone harvested.