Ersanli S, Karabuda C, Beck F, Leblebicioglu B
Department of Oral Implantology, School of Dentistry, Istanbul University, Istanbul, Turkey.
J Periodontol. 2005 Jul;76(7):1066-71. doi: 10.1902/jop.2005.76.7.1066.
Currently, there is no available clinical tool to evaluate the amount of osseointegration and stability around dental implants. It has been recently suggested that changes in the stiffness of an implant in bone during healing may be monitored by using resonance frequency analysis (RFA). The aim of this study was to determine whether RFA can be integrated into the routine clinical evaluation of initial healing of dental implants.
Thirty-one patients (18 female and 13 male; mean age of 51.7 years) were included into this study. A total of 122 implants and three different, but comparable, implant designs were evaluated by using RFA. The specific transducer for each implant system was used. ISQ (implant stability quotient) readings were obtained for each implant at the time of surgery, 3 and 6 weeks postoperatively, and at the time of loading (3 or 6 months following surgery). Data were analyzed for different healing times, various anatomical locations, implant length, and type. Average time in function was 12 months.
Two implants failed during healing. Implant stability was higher on the mandible compared to the maxilla for each implant system studied (Mann-Whitney test, P <0.01). ISQ readings decreased significantly at 3 and 6 weeks post-surgery compared to readings obtained at surgery (Wilcoxon matched pairs sign-rank tests, P <0.01). A recovery to the initial ISQ levels was noted at the time of implant loading. The possible effects of different types and lengths of implants to ISQ readings were examined.
Results of this study support the need for a clinical tool to evaluate dental implant stability prior to loading, especially for implants placed in the maxilla. It appears that implant stability is weakest at 3 to 6 weeks in one-stage non-loaded dental implants. ISQ readings can be used to determine different healing phases and the stability of dental implants. However, it is difficult to define a general standardized range of ISQ readings for successful implant integration for various implant systems. Thus, RFA values/ISQ levels should be calibrated for each implant system separately. Further studies are needed to compare the early changes seen in immediately loaded dental implants and to determine whether there is any time in which the total recovery in ISQ levels may occur.
目前，尚无可用的临床工具来评估牙种植体周围的骨结合量和稳定性。最近有人提出，愈合过程中种植体在骨内的刚度变化可通过共振频率分析（RFA）进行监测。本研究的目的是确定RFA是否可纳入牙种植体初始愈合的常规临床评估中。
31例患者（18例女性，13例男性；平均年龄51.7岁）纳入本研究。使用RFA对总共122颗种植体和三种不同但具有可比性的种植体设计进行评估。使用每种种植体系统的特定换能器。在手术时、术后3周和6周以及加载时（手术后3或6个月）获取每个种植体的ISQ（种植体稳定性商数）读数。对不同愈合时间、不同解剖位置、种植体长和类型的数据进行分析。平均功能时间为12个月。
两颗种植体在愈合过程中失败。对于所研究的每种种植体系统，下颌骨上的种植体稳定性高于上颌骨（曼-惠特尼检验，P<0.01）。与手术时获得的读数相比，术后3周和6周时的ISQ读数显著降低（威尔科克森配对符号秩检验，P<0.01）。在种植体加载时，注意到恢复到初始ISQ水平。研究了不同类型和长度的种植体对ISQ读数的可能影响。
本研究结果支持需要一种临床工具来评估加载前牙种植体的稳定性，特别是对于上颌骨中的种植体。似乎在一期未加载的牙种植体中，种植体稳定性在3至6周时最弱。ISQ读数可用于确定不同的愈合阶段和牙种植体的稳定性。然而，难以针对各种种植体系统成功种植体整合定义一个通用的标准化ISQ读数范围。因此，应分别针对每种种植体系统校准RFA值/ISQ水平。需要进一步研究来比较即刻加载牙种植体中观察到的早期变化，并确定是否存在ISQ水平完全恢复的任何时间段。
