Nkenke Emeka, Hahn Michael, Weinzierl Konstanze, Radespiel-Tröger Martin, Neukam Friedrich Wilhelm, Engelke Klaus
Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Germany.
Clin Oral Implants Res. 2003 Oct;14(5):601-9. doi: 10.1034/j.1600-0501.2003.00937.x.
The aim of the present study was to determine the correlation between the primary stability of dental implants placed in edentulous maxillae and mandibles, the bone mineral density and different histomorphometric parameters. After assessing the bone mineral density of the implant sites by computed tomography, 48 stepped cylinder screw implants were installed in four unfixed human maxillae and mandibles of recently deceased people who had bequeathed their bodies to the Anatomic Institute I of the University of Erlangen-Nuremberg for medical-scientific research. Peak insertion torque, Periotest values and resonance frequency analysis were assessed. Subsequently, histologic specimens were prepared, and bone-to-implant contact, the trabecular bone pattern factor (TBPf), the density of trabecular bone (BV/TV) and the height of the cortical passage of the implants were determined. The correlation between the different parameters was calculated statistically. The mean resonance frequency analysis values (maxilla 6130.4+/-363.2 Hz, mandible 6424.5+/-236.2 Hz) did not correlate with the Periotest measurements (maxilla 13.1+/-7.2, mandible -7.9+/-2.1) and peak insertion torque values (maxilla 23.8+/-2.2 N cm, mandible 45.0+/-7.9 N cm) (P=0.280 and 0.193, respectively). Again, no correlations could be found between the resonance frequency analysis, the bone mineral density (maxilla 259.2+/-124.8 mg/cm(3), mandible 349.8+/-113.3 mg/cm3), BV/TV (maxilla 19.7+/-8.8%, mandible 34.3+/-6.0%) and the TBPf (maxilla 2.39+/-1.46 mm-1, mandible -0.84+/-3.27 mm-1) (P=0.140 and 0.602, respectively). However, the resonance frequency analysis values did correlate with bone-to-implant contact of the oral aspect of the specimens (maxilla 12.6+/-6.0%, mandible 35.1+/-5.1%) and with the height of the crestal cortical bone penetrated by the implants in the oral aspect of the implant sites (maxilla 2.1+/-0.7 mm, mandible 5.1+/-3.7 mm) (P=0.024 and 0.002, respectively). The Periotest values showed a correlation with the height of the crestal cortical bone penetrated by the implants in the buccal aspect of the implant sites (maxilla 2.5+/-1.2 mm, mandible 5.4+/-1.2 mm) (P=0.015). The resonance frequency analysis revealed more correlations to the histomorphometric parameters than the Periotest measurements. However, it seems that the noninvasive determination of implant stability has to be improved in order to give a more comprehensive prediction of the bone characteristics of the implant site.
本研究的目的是确定无牙上颌骨和下颌骨中种植体的初期稳定性、骨密度及不同组织形态计量学参数之间的相关性。通过计算机断层扫描评估种植部位的骨密度后，将48枚阶梯圆柱螺旋种植体植入4具新近死亡者的未固定人类上颌骨和下颌骨中，这些死者已将遗体遗赠给埃尔朗根 - 纽伦堡大学解剖学研究所I用于医学科研。评估峰值插入扭矩、Periotest值和共振频率分析。随后，制备组织学标本，并测定骨与种植体的接触、骨小梁模式因子（TBPf）、骨小梁骨密度（BV/TV）以及种植体皮质通道高度。对不同参数之间的相关性进行统计学计算。平均共振频率分析值（上颌骨6130.4±363.2 Hz，下颌骨6424.5±236.2 Hz）与Periotest测量值（上颌骨13.1±7.2，下颌骨 -7.9±2.1）和峰值插入扭矩值（上颌骨23.8±2.2 N cm，下颌骨45.0±7.9 N cm）均无相关性（P值分别为0.280和0.193）。同样，共振频率分析与骨密度（上颌骨259.2±124.8 mg/cm³，下颌骨349.8±113.3 mg/cm³）、BV/TV（上颌骨19.7±8.8%，下颌骨34.3±6.0%）以及TBPf（上颌骨2.39±1.46 mm⁻¹，下颌骨 -0.84±3.27 mm⁻¹）之间也无相关性（P值分别为0.140和0.602）。然而，共振频率分析值与标本口腔侧的骨与种植体接触（上颌骨12.6±6.0%，下颌骨35.1±5.1%）以及种植部位口腔侧种植体穿透的嵴顶皮质骨高度（上颌骨2.1±0.7 mm，下颌骨5.1±3.7 mm）具有相关性（P值分别为0.024和0.002）。Periotest值与种植部位颊侧种植体穿透的嵴顶皮质骨高度（上颌骨2.5±1.2 mm，下颌骨5.4±1.2 mm）具有相关性（P = 0.015）。与Periotest测量相比，共振频率分析显示出与组织形态计量学参数的更多相关性。然而，似乎为了更全面地预测种植部位的骨特性，植入稳定性的非侵入性测定方法还需改进。
