种植区骨密度、最大扭矩值、稳定系数对牙缺失种植修复患者种植体稳定性的影响

Effects of Bone Mineral Density,Maximum Torque Value and Stability Coefficient on Implant Stability of Patients with Absence of Teeth Undergoing Implant Restoration

目的分析种植区骨密度、最大扭矩值对牙缺失种植修复患者种植体稳定性的影响。方法选取2021年9月至2023年2月行牙缺失种植修复患者80例,共304枚种植点,锥形束CT测量种植区颌面骨密度、周围牙槽骨厚度,用种植机测量种植体植入旋入扭矩值(insertion torgue value,ITV),种植体稳定性测量仪测量种植体稳定系数(implant stability quotient,ISQ),X线影像软件测量各种植体边缘骨吸收情况。比较不同种植区域、骨质量的骨密度、ITV及ISQ值,分析骨密度与ITV及ISQ值的相关性;根据术后3个月种植体情况分为稳定组、不稳定组,统计2组临床资料、骨密度、ITV及ISQ值,行多因素Logistic回归分析种植体稳定性的影响因素。结果不同种植区骨密度比较:下颌前牙>下颌后牙>上颌前牙>上颌后牙(P<0.05);不同种植区ISQ值、ITV比较:下颌后牙>下颌前牙>上颌后牙>上颌前牙(P<0.05);各种植区骨密度、ISQ值、ITV均表现为下颌区域明显高于上颌区域(P<0.05)。不同骨质量的骨密度、ISQ值、ITV比较:Ⅰ类骨>Ⅱ类骨、Ⅲ类骨>Ⅳ类骨(P<0.05)。骨密度与ITV及ISQ值均呈正相关(r=0.801、0.783,P<0.05),ITV与ISQ值呈正相关(r=0.771,P<0.05)。不稳定组骨密度、ITV、ISQ值低于稳定组(P<0.01)。骨密度、ITV、ISQ值是种植体稳定性的影响因素(P<0.01)。结论牙缺失种植修复患者种植区骨密度、ITV与种植体稳定性存在正相关性,此外种植体稳定性还受种植体直径、骨质量、种植区因素影响。

Objective To analyze the effects of bone mineral density(BMD)and maximum torque value on implant stability in patients with absence of teeth undergoing implant restoration.Methods A total of 304 implant sites were selected from 80 patients with absence of teeth undergoing implant restoration from September 2021 to February 2023.Cone-beam CT was used to measure maxillofacial bone density and the thickness of surrounding alveolar bone in the implant area.The implant insertion torque value(ITV)was measured by the implant machine,and the implant stability coefficient(ISQ)was measured by the implant stability measuring instrument.Bone resorption at the edge of each implant was measured by X-ray imaging soft-ware.BMD,ITV and ISQ values of different implant areas and bone mass were compared,and the correlation of BMD with ITV and ISQ values was analyzed.Based on the condition of the implant at three months after surgery,the implants were divided in-to stable group and unstable group.Clinical data,BMD,ITV and ISQ values of the two groups were analyzed,and multivariate Logistic regression analysis was performed to analyze the influencing factors of implant stability.Results BMD in different planting areas was compared,which was the highest in mandibular anterior teeth,followed by mandibular posterior teeth,max-illary anterior teeth and maxillary posterior teeth(P<0.05).Comparison of ISQ value and ITV in different planting areas showed the highest value in mandibular posterior teeth,followed by mandibular anterior teeth,maxillary posterior teeth and maxillary anterior teeth(P<0.05).BMD,ISQ value and ITV in mandibular region were significantly higher than those in maxil-lary region(P<0.05).The BMD,ISQ value and ITV of different bone mass were compared,showing the highest value in Class I bone,fllowed by Class II bone,class II bone and Class IV bone(P<0.05).BMD was positively correlated with both ITV and ISQ values(r=0.801,0.783,P<0.05),and ITV was positively correlated with ISQ values(r=0.771,P<0.05).BMD,ITV and ISQ values in unstable group were lower than those in stable group(P<0.01).BMD,ITV and ISQ were the factors affecting implant stability(P<0.01).Conclusion BMD in different planting areas and ITV of patients with absence of teeth undergoing implant restoration were positively correlated with implant stability.In addition,implant stability was also affected by implant diameter,bone quality and planting area.