Dasmah Amir, Kashani Hossein, Thor Andreas, Rasmusson Lars
Department of Oral & Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Oral & Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Craniomaxillofac Surg. 2014 Sep;42(6):796-800. doi: 10.1016/j.jcms.2013.11.014. Epub 2013 Nov 16.
Bone augmentation before treatment with endosseous implants is a common procedure for rehabilitation of the edentulous jaw. Both machined and surface modified implants have been used in one-stage and two-stage surgery protocols with varying results and survival rates. The influence of surface modification on the integration of implants has been documented in both non-grafted and grafted bone. The aim of this study was to compare the integration and stability of surface modified fluoridated vs. machined implants when placed simultaneously with an onlay bone graft.
Eight rabbits were used in this study. A disc shaped bone graft was harvested from each side of the sagittal suture of the calvarial bone and fixed bi-cortically to the proximal tibial metaphysis by means of a dental implant, 9 mm long and 3.5 mm in diameter with a smooth machined surface as control and a blasted, fluoridated surface as test. Test and control sides were randomised. After a healing time of 8 weeks, the rabbits were sacrificed and the implants were removed en block for light microscopic analysis. Bone to implant contact (BIC) was registered as well as the amount of bone filling a rectangle indicating a region of interest (ROI) in the grafted area. Resonance frequency analysis (RFA) was conducted both at the time of surgery and at the end of the study.
Our results showed statistically significant differences in BIC within the grafted area and the total bone to implant contact between the test and control sides in favour of the surface modified implants. The bone area filling the threads within a region of interest showed no statistically significant difference between the test and control sides. RFA showed higher implant stability with significant differences at the time of sacrifice in favour of the fluoridated implants.
Surface modified fluoridated implants showed a higher degree of osseointegration and stability in onlay bone grafts compared with control implants with machined surface texture.
在进行骨内种植体治疗前进行骨增量是无牙颌修复的常见程序。机械加工和表面改性种植体已用于一期和二期手术方案，结果和存活率各不相同。表面改性对种植体在非移植骨和移植骨中整合的影响已有文献记载。本研究的目的是比较表面改性氟化种植体与机械加工种植体在与覆盖骨移植同时植入时的整合情况和稳定性。
本研究使用了8只兔子。从颅骨矢状缝的每一侧获取圆盘状骨移植块，并通过一枚9毫米长、直径3.5毫米、表面光滑的机械加工种植体将其双皮质固定于胫骨近端干骺端，作为对照，以及一枚表面喷砂氟化的种植体作为测试。测试侧和对照侧随机分配。在愈合8周后，处死兔子，将种植体整块取出进行光学显微镜分析。记录骨与种植体接触（BIC）情况以及填充移植区域中表示感兴趣区域（ROI）的矩形的骨量。在手术时和研究结束时均进行共振频率分析（RFA）。
我们的结果显示，在移植区域内的BIC以及测试侧和对照侧之间的总骨与种植体接触方面存在统计学上的显著差异，表面改性种植体更具优势。在测试侧和对照侧之间，填充感兴趣区域内螺纹的骨面积没有统计学上的显著差异。RFA显示种植体稳定性更高，在处死时存在显著差异，氟化种植体更具优势。
与具有机械加工表面纹理的对照种植体相比，表面改性氟化种植体在覆盖骨移植中显示出更高程度的骨整合和稳定性。
