Ostman Pär-Olov, Hellman Mats, Wendelhag Inger, Sennerby Lars
Department of Biomaterials, Institute for Surgical Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
Int J Prosthodont. 2006 Jan-Feb;19(1):77-83; discussion 84.
The knowledge of what levels of primary stability can be obtained in different jawbone regions and of what factors influence primary stability is limited. The objective of this study was to evaluate primary stability by resonance frequency analysis (RFA) measurements of implants placed according to a surgical protocol that aimed for high primary stability. The aim was also to correlate RFA measurements with factors related to the surgical technique, the patient, and implant design.
A total of 905 Brånemark dental implants used in 267 consecutive patients were measured with RFA at the time of placement surgery.
A mean ISQ value of 67.4 (SD 8.6) was obtained for all implants. Univariate analyses with the implant or patient as unit showed higher ISQ values in men compared with women, in mandibles compared with maxillae, in posterior compared with anterior sites, and for wide-platform implants in comparison with regular/narrow-platform implants. There was a correlation between bone quality and primary stability, with lower ISQ values obtained for implants placed in softer bone. A lower stability was seen with increased implant length. A stepwise multiple regression analysis using the patient as unit showed that jaw type and gender had independent effects on primary stability.
The results suggest that factors related to bone density and implant diameter/length may affect the level of primary implant stability. Furthermore, greater stability was observed in male than in female patients. High primary implant stability was achieved in all jaw regions, although the use of thinner drills and/or tapered implants cannot fully compensate for the effect of soft bone. The research design does not permit conclusions regarding long-term treatment outcome with implants.
关于在不同颌骨区域可获得何种水平的初期稳定性以及哪些因素影响初期稳定性的知识有限。本研究的目的是通过对按照旨在实现高初期稳定性的手术方案植入的种植体进行共振频率分析(RFA)测量来评估初期稳定性。其目的还在于将RFA测量结果与手术技术、患者及种植体设计相关的因素进行关联。
在267例连续患者中使用的总共905枚Brånemark牙科种植体在植入手术时用RFA进行了测量。
所有种植体的平均植入稳定性商数(ISQ)值为67.4(标准差8.6)。以种植体或患者为单位的单因素分析显示,男性的ISQ值高于女性,下颌骨的高于上颌骨,后部的高于前部,宽平台种植体的高于常规/窄平台种植体。骨质量与初期稳定性之间存在相关性,植入较软骨质中的种植体获得的ISQ值较低。随着种植体长度增加,稳定性降低。以患者为单位进行的逐步多元回归分析表明,颌骨类型和性别对初期稳定性有独立影响。
结果表明,与骨密度以及种植体直径/长度相关的因素可能会影响种植体初期稳定性水平。此外,观察到男性患者的稳定性高于女性患者。尽管使用较细的钻头和/或锥形种植体不能完全补偿软骨质的影响,但在所有颌骨区域均实现了较高的种植体初期稳定性。该研究设计不允许得出关于种植体长期治疗效果的结论。