Sagheb Keyvan, Kumar Vinay V, Azaripour Adriano, Walter Christian, Al-Nawas Bilal, Kämmerer Peer W
Department of Oral and Maxillofacial Surgery, University Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
Department of Head and Neck Surgery, Mazumdar Shaw Medical Center, Narayana Health, Bangalore, India.
Clin Oral Implants Res. 2017 Feb;28(2):207-213. doi: 10.1111/clr.12783. Epub 2016 Jan 22.
The aim of this ex vivo study was to compare implant insertion procedures using piezosurgery and conventional drilling in different qualities of bone. Implant bed preparation time, generated heat, and primary implant stability were analyzed.
Fresh ex vivo porcine bone block samples (cancellous, mixed, and cortical bone) were obtained. The bone quality was quantified by ultrasound transmission velocity (UTV). Each bone sample received three implants of the same diameter using each of the techniques of piezosurgery and conventional twist drills. Time for preparation was taken and the temperature while performing the osteotomy was measured using infrared spectroscopy. The primary implant stability after osteotomy was measured using resonance frequency analysis (RFA) and extrusion torque (ET). ANOVA with post hoc Tukey test was carried out to compare the values for the three different groups.
The UTV values strongly correlated with the density of the bone samples. There was a significant increase in time (threefold, P < 0.05 [302 s vs. 122 s in cortical bone]) but no difference in the temperature for the piezo group (~37°C in cortical bone). Regardless of the osteotomy technique, there was a statistically significant increase in RFA and ET values in implants inserted in cancellous bone (RFA: piezo 77, drill 76; ET: piezo 22, drill 21), mixed bone (RFA: piezo 85, drill 86; ET: piezo 105, drill 61), and cortical bone (RFA: piezo 90, drill 87; ET piezo 184, drill 79) samples, respectively (P < 0.05). In between the different osteotomy groups, there was no difference in the RFA values but significant higher ET values in mixed/cortical bone samples in favor for the piezosurgery group.
Piezosurgery and conventional implant bed drilling procedure do have similar mechanical outcomes regarding primary stability with high RFA values, but the preparation does need more time for piezosurgery group, so that piezosurgery might be a valuable tool in only very specific cases for implant bed preparation.
本体外研究旨在比较在不同质量骨中使用压电手术和传统钻孔进行种植体植入的操作过程。分析种植窝预备时间、产生的热量和种植体初期稳定性。
获取新鲜的体外猪骨块样本（松质骨、混合骨和皮质骨）。通过超声传播速度（UTV）对骨质量进行量化。每个骨样本使用压电手术和传统麻花钻技术分别植入三枚相同直径的种植体。记录预备时间，并使用红外光谱法测量截骨时的温度。截骨后使用共振频率分析（RFA）和挤压扭矩（ET）测量种植体初期稳定性。采用方差分析和事后Tukey检验比较三组不同的值。
UTV值与骨样本密度密切相关。压电手术组的时间显著增加（增加了两倍，P < 0.05[皮质骨中为302秒对122秒]），但皮质骨中压电手术组的温度无差异（约37°C）。无论截骨技术如何，植入松质骨（RFA：压电手术77，钻孔76；ET：压电手术22，钻孔21）、混合骨（RFA：压电手术85，钻孔86；ET：压电手术105，钻孔61）和皮质骨（RFA：压电手术90，钻孔87；ET压电手术184，钻孔79）样本中的种植体，其RFA和ET值均有统计学显著增加（P < 0.05）。在不同截骨组之间，RFA值无差异，但混合/皮质骨样本中压电手术组的ET值显著更高。
压电手术和传统种植窝钻孔操作在初期稳定性方面具有相似的力学结果，RFA值较高，但压电手术组的预备时间更长，因此压电手术可能仅在非常特定的种植窝预备情况下是一种有价值的工具。
