Irinakis Tassos, Wiebe Colin
Faculty of Dentistry, University of British Columbia (UBC), Westbrook Mall,Vancouver, BC.
J Oral Implantol. 2009;35(6):277-82. doi: 10.1563/AAID-JOI-D-09-00020.1.
The aim of this paper was to determine the torque resistance of this new implant during placement in different types of bone, immediate placement into sockets, and in grafted bone. The torque at time of placement serves as an indication of initial stability, which is accepted as an important factor for implant osseointegration and immediate loading. Within a 13-month period, 140 NobelActive implants in 84 consecutive patients were placed into types I-IV bone in fresh sockets, and into grafted bone (both in maxillary sinuses and on the facial alveolar surfaces where bone had been lost). The final torque was measured with a manual torque control wrench as manufactured by Nobel Biocare for clinical use with this type of implant. One hundred forty implants with 3.5 to 5 mm diameters and 10 to 15 mm lengths were placed in different types of bone, either as delayed or immediate implants into fresh extraction sockets. These implants demonstrated a mean torque stability value of 50.8 Ncm. The average insertion torque for delayed implants was 49.7 Ncm. For immediate implants the average torque was 52.6 Ncm. Placement into soft bone was also favorable at an average of 47.9 Ncm. Typical straight walled and tapered implants generally exhibit 10 to 35 Ncm insertion torques. The NobelActive implant consistently reaches higher torque levels. This may indicate they are more favorably suited to early provisionalization and loading. Soft bone (type IV) did not seem to decrease significantly the torque of insertion of these implants. Further longer term studies are needed to investigate whether this indeed makes these implants more suited for early provisionalization and loading than traditional root form. Long term studies are also needed to investigate maintenance of bone levels surrounding these implants.
本文的目的是确定这种新型种植体在植入不同类型的骨、即刻植入牙槽窝以及植入骨移植部位时的抗扭矩能力。植入时的扭矩可作为初始稳定性的指标，而初始稳定性是种植体骨结合和即刻负重的一个重要因素。在13个月的时间里，为84例连续患者植入了140颗NobelActive种植体，这些种植体被植入新鲜牙槽窝的I-IV型骨以及骨移植部位（上颌窦和骨缺损的面部牙槽嵴表面）。使用诺贝尔生物公司生产的用于此类种植体临床操作的手动扭矩控制扳手测量最终扭矩。140颗直径为3.5至5毫米、长度为10至15毫米的种植体被植入不同类型的骨中，作为延期或即刻种植体植入新鲜拔牙窝。这些种植体的平均扭矩稳定性值为50.8 Ncm。延期种植体的平均植入扭矩为49.7 Ncm。即刻种植体的平均扭矩为52.6 Ncm。植入软质骨时的平均扭矩也较好，为47.9 Ncm。典型的直壁和锥形种植体通常表现出10至35 Ncm的植入扭矩。NobelActive种植体始终能达到更高的扭矩水平。这可能表明它们更适合早期临时修复和负重。软质骨（IV型）似乎并未显著降低这些种植体的植入扭矩。需要进一步的长期研究来调查这是否真的使这些种植体比传统牙根形态更适合早期临时修复和负重。还需要长期研究来调查这些种植体周围骨水平的维持情况。
