Hirota Makoto, Ozawa Tomomichi, Iwai Toshinori, Ogawa Takahiro, Tohnai Iwai
Int J Oral Maxillofac Implants. 2016 May-Jun;31(3):676-86. doi: 10.11607/jomi.4115.
The objective of this study was to compare the rate of implant stability development of as-received and photofunctionalized dental implants in regular and complex cases.
Forty-nine implants (24 as-received and 25 photofunctionalized) placed in regular or complex cases (simultaneous guided bone regeneration, sinus elevation, or fresh extraction sockets) were studied. Photofunctionalization was performed by ultraviolet (UV) treatment of implants for 15 minutes using a photo device immediately prior to placement, and the generation of superhydrophilicity was confirmed. Implant stability was evaluated by measuring the implant stability quotient (ISQ) at placement (ISQ1) and at stage-two surgery (ISQ2). The rate of implant stability development was evaluated by calculating the osseointegration speed index (OSI), defined as the ISQ increase per month ([ISQ2-ISQ1]/healing time in months). The percentage of innate bone support at placement was evaluated clinically and radiographically.
The average OSI was considerably greater for photofunctionalized implants (3.7 ± 2.9) than for as-received implants (0.0 ± 1.0). The OSI in complex cases was 4.2 ± 3.2 for photofunctionalized implants and 0.2 ± 0.9 for as-received implants. The OSI in cases with simultaneous sinus elevation was 5.5 ± 3.5 for photofunctionalized implants and 0.2 ± 1.1 for as-received implants. Photofunctionalized implants showed significantly higher ISQ2 values than as-received implants. Photofunctionalized implant ISQ2 values were greater than 60, regardless of primary stability and innate bone support at placement. In multivariate analysis including the effects of photofunctionalization, age and sex of patients, and diameter and length of implants, photofunctionalization showed the strongest influence on the OSI for both regular and complex cases, while other factors influenced the OSI only in certain conditions.
Photofunctionalization accelerated the rate and enhanced the final level of implant stability development compared with as-received implants, particularly for implants placed into poor-quality bone and other complex cases. Photofunctionalization was a stronger determinant of implant stability than all the other tested implant- and host-related factors.
本研究的目的是比较在常规和复杂病例中,未处理的和光功能化的牙科种植体的种植体稳定性发展速率。
研究了49颗种植体(24颗未处理的和25颗光功能化的),这些种植体被植入常规或复杂病例(同时引导骨再生、上颌窦提升或新鲜拔牙窝)中。在种植体植入前,立即使用光装置对种植体进行15分钟的紫外线(UV)处理以实现光功能化,并确认超亲水性的产生。通过在植入时(ISQ1)和二期手术时(ISQ2)测量种植体稳定性商数(ISQ)来评估种植体稳定性。通过计算骨结合速度指数(OSI)来评估种植体稳定性发展速率,骨结合速度指数定义为每月ISQ的增加量([ISQ2 - ISQ1]/愈合月数)。通过临床和影像学评估植入时固有骨支持的百分比。
光功能化种植体的平均OSI(3.7±2.9)显著高于未处理的种植体(0.0±1.0)。在复杂病例中,光功能化种植体的OSI为4.2±3.2,未处理的种植体为0.2±0.9。在上颌窦同时提升的病例中,光功能化种植体的OSI为5.5±3.5,未处理的种植体为0.2±1.1。光功能化种植体的ISQ2值显著高于未处理的种植体。无论植入时的初始稳定性和固有骨支持如何,光功能化种植体的ISQ2值均大于60。在包括光功能化、患者年龄和性别以及种植体直径和长度影响的多变量分析中,对于常规和复杂病例,光功能化对OSI的影响最强,而其他因素仅在特定条件下影响OSI。
与未处理的种植体相比,光功能化加速了种植体稳定性发展的速率并提高了最终水平,特别是对于植入到骨质较差的部位和其他复杂病例中的种植体。光功能化是比所有其他测试的种植体相关和宿主相关因素更强的种植体稳定性决定因素。