Heidemann Wolfgang, Terheyden Hendrik, Louis Gerlach Klaus
Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. KL Gerlach), Otto von Guericke University, Magdeburg, Germany
J Maxillofac Surg. 2001 Apr;29(2):69-74. doi: 10.1054/jcms.2000.0179.
Aim: A comparison of metal/osseous interface and bone remodelling after insertion of different types of titanium bone screws in vivo. Material: Samples of five of each of the following bone screw types were inserted into the anterior wall of the frontal sinus of five Göttingen minipigs: self-tapping micro- (1.5 mm) and miniscrews (2.0 mm) or drill free micro- (1.5 mm) and miniscrews (2.0 mm) (Martin Medizintechnik, Tuttlingen, Germany). Screw length was 7 mm. Methods: Sequential intraperitoneal injections of fluorochromes were performed between the second and ninth postoperative week. After 6 months the pigs were sacrificed, the screw-bone-blocks resected, and microradiographic, histological and fluorescence microscopical examinations were carried out. Results: Using drill free screws, mean screw/bone contact was 88.4% (miniscrews), or 93.8% (microscrews). With self-tapping miniscrews it was 54.9%, but in microscrews 81%; the differences were statistically significant (t -test: p<0.05). By fluorescence microscopy, the amount of bone remodelling (ratio of residual vs. newly formed bone) was measured. Significantly more of the residual bone was found in the region of the screw threads using drill free screws (miniscrews: mean 71.8%, microscrews: mean 67.9%) than in the region of screw threads with self-tapping screws (miniscrews: mean 33.1%, microscrews: mean 42.4%). Conclusion: The present data support the view that screw/bone contact with drill free screws was superior to that of self-tapping screws; the greater amount of original bone in the threads of drill free screws demonstrated that the insertion of drill free screws did not cause harm to the surrounding bone. Both results are important for osteosynthesis in regions where thin cortical bone is present, such as the central midface. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.
比较不同类型钛骨螺钉在体内植入后的金属/骨界面及骨重塑情况。材料：将以下每种骨螺钉各5个样本植入5只哥廷根小型猪的额窦前壁：自攻微型（1.5毫米）和小型螺钉（2.0毫米）或免钻微型（1.5毫米）和小型螺钉（2.0毫米）（德国图特林根的Martin Medizintechnik公司）。螺钉长度为7毫米。方法：在术后第2周和第9周之间进行荧光染料的序贯腹腔注射。6个月后处死猪，切除螺钉-骨块，进行显微放射照相、组织学和荧光显微镜检查。结果：使用免钻螺钉时，平均螺钉/骨接触率为88.4%（小型螺钉）或93.8%（微型螺钉）。自攻小型螺钉为54.9%，微型螺钉为81%；差异具有统计学意义（t检验：p<0.05）。通过荧光显微镜测量骨重塑量（残留骨与新形成骨的比例）。在使用免钻螺钉的螺纹区域发现的残留骨明显多于自攻螺钉的螺纹区域（小型螺钉：平均71.8%，微型螺钉：平均67.9%）（小型螺钉：平均33.1%，微型螺钉：平均42.4%）。结论：目前的数据支持这样的观点，即免钻螺钉的螺钉/骨接触优于自攻螺钉；免钻螺钉螺纹中较多的原始骨表明免钻螺钉的植入对周围骨没有造成损害。这两个结果对于存在薄皮质骨的区域（如中面部中央）的骨合成很重要。版权所有2001年欧洲颅颌面外科协会。
