Möhlhenrich S C, Kniha K, Heussen N, Hölzle F, Modabber A
Department of Orthodontics, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Br J Oral Maxillofac Surg. 2016 Nov;54(9):980-986. doi: 10.1016/j.bjoms.2016.07.004. Epub 2016 Jul 22.
Preparation of implant sites affect the primary stability of implants that is necessary for osseointegration. We have investigated the effect on the primary stability of implants of three techniques used to prepare the site for implants in synthetic bone models of different densities. A total of 540 implants of varying diameters (3.3 (narrow), 4.1 (standard), and 4.8 (wide) mm) and lengths (8 or 12mm) were inserted into three artificial bone blocks (the density of which decreased from D2, D3, to D4), and we compared conventional, fully-guided, and condensing preparation of the site. After insertion, primary stability was measured using resonance frequency analysis. There were significant differences between conventional and condensing procedures (p <0.0001 in all cases) and between fully-guided and condensing procedures (p<0.01 in all cases), but there were no differences between fully-guided and conventional procedures when short implants were used, with a standard or wide diameter in low-density bone blocks (D3 and D4). In low-density bone blocks (D3 and D4) wide implants (4.8mm) compared with narrow (3.3mm) resulted in significantly better primary stability (p<0.0001 in all cases). Fully-guided preparation of the implant site is associated with increased primary stability, but is not an alternative to bone condensing. Use of longer or wider implants can increase primary stability, but the effect is less pronounced after bone condensing.
种植位点的制备会影响种植体的初期稳定性，而初期稳定性是骨结合所必需的。我们研究了在不同密度的合成骨模型中，三种用于制备种植位点的技术对种植体初期稳定性的影响。将总共540颗不同直径（3.3（窄）、4.1（标准）和4.8（宽）mm）和长度（8或12mm）的种植体植入三块人工骨块（其密度从D2、D3降至D4）中，我们比较了位点的传统制备、完全引导制备和挤压制备。植入后，使用共振频率分析测量初期稳定性。传统制备和挤压制备之间存在显著差异（所有情况均p<0.0001），完全引导制备和挤压制备之间也存在显著差异（所有情况均p<0.01），但在低密度骨块（D3和D4）中使用标准直径或宽直径的短种植体时，完全引导制备和传统制备之间没有差异。在低密度骨块（D3和D4）中，宽种植体（4.8mm）与窄种植体（3.3mm）相比，初期稳定性显著更好（所有情况均p<0.0001）。种植位点的完全引导制备与初期稳定性增加相关，但不是骨挤压的替代方法。使用更长或更宽的种植体可以增加初期稳定性，但在骨挤压后效果不太明显。
