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上颌和下颌即刻负重种植体的共振频率分析评估

A resonance frequency analysis assessment of maxillary and mandibular immediately loaded implants.

作者信息

Balshi Stephen F, Allen Fred D, Wolfinger Glenn J, Balshi Thomas J

机构信息

Prosthodontics Intermedica, Institute for Facial Esthetics, Fort Washington, Pennsylvania, USA.

出版信息

Int J Oral Maxillofac Implants. 2005 Jul-Aug;20(4):584-94.

Abstract

PURPOSE

This study evaluated the stability of implants in 51 patients following a clinical protocol of immediate functional loading. The stability during the first 3 months following implant placement was assessed according to bone type, implant location, and patient gender.

MATERIALS AND METHODS

Twenty-two male and 29 female patients were treated with 344 Brånemark System implants placed in edentulous bone or extraction sites and put into functional loading using the Teeth in a Day protocol. Each implant was tested for primary stability with resonance frequency analysis (RFA) at the time of implant placement, and RFA was performed at examinations 30, 60, and 90 days following surgery.

RESULTS

The analysis was based on the 276 implants that were successfully measured using RFA at all postoperative intervals. The clinical implant survival rate was 98.5% for the total population. RFA showed a decrease in bone-implant stability in the first month after implant placement from 70.35 +/- 0.5 to 66.38 +/- 0.50, followed by increases in stability in the second and third months (68.01 +/- 0.50 and 68.82 +/- 0.49, respectively), suggesting a process of adaptive bone remodeling around the implant. In general, lower initial stabilities were seen in softer bone types, in the posterior portions of the jaw compared to anterior areas, and in the female population.

DISCUSSION AND CONCLUSION

The results of this study suggest an immediate loading protocol should have an undisturbed period of healing for the first 2 months following implant placement. The determination of "predictor" stability levels for different clinical conditions were based on multiple splinted implants, allowing a larger surface area to withstand the distribution of the load. The most significant "predictor" values from a surgical and prosthodontic perspective are those determined in soft bone, in reduced bone, or in areas where lever arms are created as a result of long spans between the implants.

摘要

目的

本研究依据即刻功能负载的临床方案,评估了51例患者种植体的稳定性。根据骨类型、种植体位置和患者性别,对种植体植入后的前3个月内的稳定性进行了评估。

材料与方法

22例男性和29例女性患者接受了344枚Brånemark系统种植体治疗,这些种植体被植入无牙骨或拔牙位点,并采用“一日得牙”方案进行功能负载。在种植体植入时,使用共振频率分析(RFA)对每个种植体的初期稳定性进行测试,并在术后30、60和90天进行RFA检查。

结果

分析基于所有术后时间点均成功使用RFA测量的276枚种植体。总体人群的临床种植体存活率为98.5%。RFA显示,种植体植入后的第一个月,骨-种植体稳定性从70.35±0.5降至66.38±0.50,随后在第二个月和第三个月稳定性增加(分别为68.01±0.50和68.82±0.49),这表明种植体周围存在适应性骨重塑过程。一般来说,在较软的骨类型、下颌后部(与前部区域相比)以及女性人群中,初始稳定性较低。

讨论与结论

本研究结果表明,即刻负载方案在种植体植入后的前2个月应具有不受干扰的愈合期。针对不同临床情况的“预测”稳定性水平的确定基于多个夹板固定的种植体,从而允许更大的表面积来承受负载分布。从外科和修复学角度来看,最重要的“预测”值是在软质骨、骨量减少的区域或者由于种植体之间跨度较长而形成杠杆臂的区域所确定的值。

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