Rashad Ashkan, Sadr-Eshkevari Pooyan, Weuster Markus, Schmitz Inge, Prochnow Nora, Maurer Peter
Department of Oral and Maxillofacial Surgery, Klinikum Reinkenheide-Bremerhaven gGmbH, Postbrookstraße 103, 27574, Bremerhaven, Germany.
Clin Oral Implants Res. 2013 Aug;24 Suppl A100:110-4. doi: 10.1111/j.1600-0501.2011.02389.x. Epub 2012 Jan 17.
Little is known about the recently introduced ultrasonic implant site preparation. The purpose of this study was to compare material attrition and micromorphological changes after ultrasonic and conventional implant site preparations.
Implant site preparations were performed on fresh bovine ribs using one conventional (Straumann, Freiburg, Germany) and two ultrasonic (Piezosurgery; Mectron Medical Technology, Carasco, Italy and Variosurg; NSK, Tochigi, Japan) systems with sufficient saline irrigation. Sections were examined by environmental scanning electron microscopy (ESEM). Energy-dispersive X-ray spectroscopy (EDX) was performed to evaluate the metal attrition within the bone and the irrigation fluid.
After conventional osteotomy, partially destroyed trabecular structures of the cancellous bone that were loaded with debris were observed, whereas after ultrasonic implant site preparations, the anatomic structures were preserved. EDX: None of the implant site preparation methods resulted in metal deposits in the adjacent bone structures. However, within the irrigation liquid, there was significantly higher metal attrition with ultrasonic osteotomy (P < 0.0001 and P < 0.0001 for Mectron and NSK, respectively). Whereas for Straumann system used, 15.5% of the SEM/EDX findings were drill-origin metals, this percentage increased to 37.3% and 37.9% with the application of Mectron and NSK, respectively.
Ultrasonic implant site preparation is associated with the preservation of bone microarchitecture and with the increased attrition of metal particles. Therefore, copious irrigation seems to be even more essential for ultrasonic implant site preparation than for the conventional method.
对于最近引入的超声种植位点预备技术，人们了解甚少。本研究的目的是比较超声和传统种植位点预备术后的材料磨损及微观形态变化。
在新鲜牛肋骨上使用一种传统器械（德国弗赖堡的士卓曼公司生产）和两种超声器械（意大利卡拉斯科的迈创医疗科技公司生产的骨动力超声外科系统；日本枥木的NSK公司生产的Variosurg超声外科系统）进行种植位点预备，并充分冲洗。通过环境扫描电子显微镜（ESEM）检查切片。采用能量色散X射线光谱仪（EDX）评估骨内及冲洗液中的金属磨损情况。
结果 ESEM：传统截骨术后，可见松质骨小梁结构部分破坏，有碎屑附着；而超声种植位点预备术后，解剖结构得以保留。EDX：所有种植位点预备方法均未导致相邻骨结构中有金属沉积。然而，在冲洗液中，超声截骨导致的金属磨损明显更高（迈创和NSK系统分别为P < 0.0001和P < 0.0001）。对于使用的士卓曼系统，扫描电镜/能谱分析结果中15.5%的金属源自钻头；而使用迈创和NSK系统时，该比例分别增至37.3%和37.9%。
超声种植位点预备可保留骨微结构，并增加金属颗粒磨损。因此，与传统方法相比，大量冲洗对于超声种植位点预备似乎更为重要。
