Wang L, Wu Y, Perez K C, Hyman S, Brunski J B, Tulu U, Bao C, Salmon B, Helms J A
1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
J Dent Res. 2017 Apr;96(4):413-420. doi: 10.1177/0022034516683932. Epub 2017 Jan 3.
Bone condensation is thought to densify interfacial bone and thus improve implant primary stability, but scant data substantiate either claim. We developed a murine oral implant model to test these hypotheses. Osteotomies were created in healed maxillary extraction sites 1) by drilling or 2) by drilling followed by stepwise condensation with tapered osteotomes. Condensation increased interfacial bone density, as measured by a significant change in bone volume/total volume and trabecular spacing, but it simultaneously damaged the bone. On postimplant day 1, the condensed bone interface exhibited microfractures and osteoclast activity. Finite element modeling, mechanical testing, and immunohistochemical analyses at multiple time points throughout the osseointegration period demonstrated that condensation caused very high interfacial strains, marginal bone resorption, and no improvement in implant stability. Collectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability.
骨挤压被认为可使界面骨致密化，从而提高种植体的初期稳定性，但几乎没有数据能证实这两种说法。我们建立了一个小鼠口腔种植模型来验证这些假设。在上颌愈合拔牙位点制备骨切开术，方法如下：1）钻孔；2）钻孔后用锥形骨凿逐步挤压。通过骨体积/总体积和小梁间距的显著变化来衡量，挤压增加了界面骨密度，但同时也损伤了骨组织。在种植后第1天，挤压的骨界面出现微骨折和破骨细胞活性。在骨整合期的多个时间点进行的有限元建模、力学测试和免疫组织化学分析表明，挤压导致非常高的界面应变、边缘骨吸收，且种植体稳定性没有改善。总的来说，这些多尺度分析表明，挤压对种植体稳定性没有积极作用。
