自攻型种植体在即刻种植中的生物学性能研究

Study on the biological performance of self-tapping dental implants in immediate implantation

目的比较自攻型与非自攻型种植体在即刻种植方式中的初期稳定性,骨结合及新骨形成能力。为自攻型种植体临床应用提供依据。方法选取健康雄性成年Beagle实验犬36只,微创拔牙后,行种植体即刻植入术。每只实验犬下颌植入骨水平自攻型种植体(BLE)、骨水平非自攻型种植体(BL)、软组织水平自攻型种植体(TLE)、软组织水平非自攻型种植体(TL)各1枚。分别在种植体植入后4、8、12周取材,记录并分析种植体植入时的旋入扭矩。应用种植体共振频率分析仪量化分析自攻型牙种植体的初期稳定性和长期稳定性。应用micro-CT观察并计算骨体积分数(骨体积/总体积),骨小梁数量(Tb.N)、骨小梁间距(Tb.Sp)分析植体周围骨改建情况。应用荧光标记物盐酸四环素进行骨改建情况示踪标记,利用激光共聚焦显微镜观察,分析比较自攻型种植体与非自攻型种植体新生骨面积。结果对种植体植入时的植入扭矩和ISQ值进行分析,自攻组结果均优于非自攻组(P<0.05)。植入后4、8、12周的ISQ值,BLE组显著高于BL组(P<0.05),TLE组在植入后4、8周显著高于TL组,在植入后12周与TL组基本一致。骨体积分数和新生骨面积均为自攻组优于非自攻组(P<0.05)。结论在即刻种植中,自攻型种植体初期稳定性、骨结合强于非自攻型种植体,并且在新骨形成方面略强于非自攻型种植体。

Objective To compare the primary stability,osseointegration and the new bone formation ability of self-tapping and non-self-tapping implants in immediate implant,and provide basis for clinical application of self-tapping implants.Methods Thirty-six healthy male adult Beagle dogs with well-developed body were selected and numbered randomly as No.1-36.After minimally invasive tooth extraction,immediate implant placement was performed.Two self-tapping implants(BLE,TLE)and two non-self-tapping implants(BL,TL)were implanted in the mandibular of each experimental dog.Thirty-six Beagle dogs were sacrificed 4,8,and 12 weeks after implant placement.The insertion torque analysis of all implanted implants was performed,and the primary stability and the long-term stability of the self-tapping dental implants were analyzed using the resonance Frequency Analysis.Micro-CT was used to observe and calculate the bone volume fraction(bone volume/total volume,BV/TV,%)and number of trabeculae and trabecular spacing to analyze the bone remodeling around the implant.The fluorescent marker tetracycline hydrochloride was used to trace the bone remodeling.Laser confocal microscope was used to observe,analyze and compare the new bone area of self-tapping implants and non-self-tapping implants.Results Analyzing the insertion torque and ISQ value during implant placement,the results of the self-tapping group were better than those of the non-self-tapping group(P<0.05).The ISQ values of 4 weeks,8 weeks,and 12 weeks after implantation were significantly higher in the BLE group than in the BL group(P<0.05).The TLE group was significantly higher than the TL group 4 weeks and 8 weeks after implantation.However,12 weeks after implantation,the TLE group was basically consistent with the TL group.Bone volume fraction and new bone area of self-tapping group were both superior to non-self-tapping group(P<0.05).Conclusion In immediate implantation,the primary stability and the osseointegration ability of self-tapping implants are better than those of non-self-tapping implants,while new bone formation ability is a little stronger.