Quinlan Paul, Nummikoski Pirkka, Schenk Robert, Cagna David, Mellonig James, Higginbottom Frank, Lang Klaus, Buser Daniel, Cochran David
Department of Dental Diagnostic Science, University of Texas Health Science Center at San Antonio, 78229-3900, USA.
Int J Oral Maxillofac Implants. 2005 May-Jun;20(3):360-70.
The purpose of this investigation was to determine whether early and immediate loading of dental implants resulted in adverse consequences as determined clinically, radiographically, and histologically.
In a canine model, 48 sand-blasted, large-grit, acid-etched (SLA) surfaced implants were placed at 4 different times before definitive restoration and loading. These times were 3 months (group A), 21 days (group B), 10 days (group C), and 2 days (immediately) (group D) before loading. Each implant was restored at the same time with a single gold screw-retained crown. Immediately after restoration all crowns were placed in function. Standardized periapical radiographs were made 1, 2, and 3 months after restoration. At the end of the study, block sections were obtained for histologic examination. Changes in crestal bone height on the mesial and distal aspects of each implant and the change in bone density of the coronal 3 mm of crestal bone were recorded. Primary, secondary, and total bone-to-implant contact; bone marrow-to-implant contact; and connective tissue-to-implant contact were evaluated histologically.
All implants were osseointegrated at the end of the study; no clinical failures of integration were noted. The changes in crestal bone heights for groups A, B, C, and D (means +/- SE) were 0.02 +/- 0.07 mm, 0.30 +/- 0.08 mm, 0.15 +/- 0.08 mm, and 0.35 +/- 0.18 mm, respectively. Total bone-to-implant contact for the 4 groups was 69.1%, 71.3%, 74.6%, and 75.2%, respectively (P > .57).
Under the conditions of this study no statistically significant differences were noted between the 4 different loading protocols for any of the parameters recorded. This finding is consistent with other recent studies and case reports.
The findings of this study indicate that early and immediate loading of single-unit SLA surfaced implants was possible in this model. (More than 50 references.)
本研究的目的是确定牙种植体的早期即刻加载是否会导致临床、影像学和组织学上确定的不良后果。
在犬模型中，在最终修复和加载前的4个不同时间植入48颗喷砂、大颗粒、酸蚀（SLA）表面的种植体。这些时间分别是加载前3个月（A组）、21天（B组）、10天（C组）和2天（即刻）（D组）。每个种植体同时用单个金螺丝固位冠进行修复。修复后立即让所有冠行使功能。在修复后1、2和3个月拍摄标准化根尖片。在研究结束时，获取块状切片进行组织学检查。记录每个种植体近中和远中侧牙槽嵴骨高度的变化以及牙槽嵴骨冠方3mm的骨密度变化。组织学评估初级、次级和总的骨与种植体接触；骨髓与种植体接触；以及结缔组织与种植体接触。
在研究结束时所有种植体均实现骨整合；未观察到临床整合失败。A组、B组、C组和D组牙槽嵴骨高度的变化（均值±标准误）分别为0.02±0.07mm、0.30±0.08mm、0.15±0.08mm和0.35±0.18mm。4组总的骨与种植体接触率分别为69.1%、71.3%、74.6%和75.2%（P>.57）。
在本研究条件下，记录的任何参数在4种不同加载方案之间均未观察到统计学上的显著差异。这一发现与其他近期研究和病例报告一致。
本研究结果表明，在该模型中早期即刻加载单单位SLA表面种植体是可行的。（超过50篇参考文献。）
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