Duyck J, Van Oosterwyck H, Vander Sloten J, De Cooman M, Puers R, Naert I
Department of Prosthetic Dentistry, BIOMAT Research Group, K.U.Leuven, U.Z. St. Raphaël, Kapucijnenvoer 33, B-3000 Leuven, Belgium.
J Oral Rehabil. 2001 Mar;28(3):226-33.
The fit of implant supported fixed prostheses is said to be of clinical concern because of the rigid fixation of an oral implant in its surrounding bone. The influence of the torque sequence of the set screws during fixation of implant supported fixed full prostheses on the final pre-load was investigated in vitro. No significant effect of the torque sequence of the set screws on the final pre-load was observed. The main objective of this study was to quantify and qualify the pre-load in vivo on implants supporting a fixed full prosthesis. This was performed when the prostheses were supported by all five or six implants and was repeated when the prostheses were supported by only four and three implants. A total of 13 patients with a fixed full implant supported prosthesis were selected. The existing abutments were changed for strain gauged abutments. After tightening the set screws with a torque of 10 N cm, the pre-load conditions were registered. The average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 323 N (43 N), 346 N (59 N), 307 N (60 N) 21 N cm (3 N cm) and 21 N cm (2 N cm), 23 N cm (5 N cm), respectively. In addition, the pre-load was registered after fixation of a machined gold cylinder, as delivered by the manufacturer, on each of the supporting implants, representing the 'optimal fit' situation. The corresponding average (SEM) axial forces and bending moments in case of five or six, four and three supporting implants were 426 N (36 N), 405 N (40 N), 413 N (46 N) and 8 N cm (1 N cm), 8 N cm (1 N cm), 8 N cm (1 N cm), respectively. The induced axial forces after tightening the prostheses were significantly lower then after tightening the gold cylinder in case of five or six supporting implants (P < 0.02). The induced bending moments after tightening the prostheses were statistically significantly higher (P < 0.0001) then after tightening the gold cylinder in all test conditions (five or six, four or three supporting implants). This study underlines the static load present after screw tightening implant supported fixed full prostheses.
由于口腔种植体在其周围骨组织中固定牢固，种植体支持的固定修复体的适配性被认为是临床关注的问题。体外研究了种植体支持的固定全口修复体固定过程中定位螺钉扭矩顺序对最终预紧力的影响。未观察到定位螺钉扭矩顺序对最终预紧力有显著影响。本研究的主要目的是量化和鉴定支持固定全口修复体的种植体在体内的预紧力。当修复体由全部五颗或六颗种植体支持时进行该操作，当修复体仅由四颗和三颗种植体支持时重复该操作。总共选择了13例佩戴种植体支持的固定全口修复体的患者。将现有的基台更换为应变片式基台。以10 N cm的扭矩拧紧定位螺钉后，记录预紧力情况。在有五颗或六颗、四颗和三颗支持种植体的情况下，平均（标准误）轴向力和弯矩分别为323 N（43 N）、346 N（59 N）、307 N（60 N）、21 N cm（3 N cm）以及21 N cm（2 N cm）、23 N cm（5 N cm）。此外，在每个支持种植体上固定制造商提供的加工金圆柱体后记录预紧力，代表“最佳适配”情况。在有五颗或六颗、四颗和三颗支持种植体的情况下，相应的平均（标准误）轴向力和弯矩分别为426 N（36 N）、405 N（40 N）、413 N（46 N）以及8 N cm（1 N cm）、8 N cm（1 N cm）、8 N cm（1 N cm）。在有五颗或六颗支持种植体的情况下，拧紧修复体后产生的轴向力显著低于拧紧金圆柱体后（P < 0.02）。在所有测试条件下（五颗或六颗、四颗或三颗支持种植体），拧紧修复体后产生的弯矩在统计学上显著高于拧紧金圆柱体后（P < 0.0001）。本研究强调了拧紧种植体支持的固定全口修复体后存在静载荷。
