Lin Yen-Ting, Hong Adrienne, Peng Ying-Chin, Hong Hsiang-Hsi
1 Department of Periodontology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
2 College of Medicine, Chang Gung University, Taipei, Taiwan.
J Oral Implantol. 2017 Apr;43(2):131-138. doi: 10.1563/aaid-joi-D-16-00101. Epub 2017 Jan 3.
Clinical decisions regarding the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited. The objective was to evaluate the stability of implants placed using 2 surgical techniques, selected according to the initial width of the mandibular posterior edentulous ridge, with D bone density, during a 12-week period. Fifty-eight implants in 33 patients were evaluated. Thirty-two implants in 24 patients were positioned using the osteotome expansion technique, and 26 fixtures in 17 patients were installed using the conventional drilling technique. The implant stability quotient values were recorded at weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 postsurgery and evaluated using analysis of variance, independent, and paired t tests. Calibrated according to the stability reading of a 3.3-mm diameter implant, the osteotome expansion group was associated with a lower bone density than the conventional group (64.96 ± 6.25 vs 68.98 ± 5.06, P = .011). The osteotome expansion group achieved a comparable primary stability (ISQ, P = .124) and greater increases in secondary stability (ISQ, P = .07) than did the conventional technique. A D quality ridge with mild horizontal deficiency is expandable by using the osteotome expansion technique. Although the 2 groups presented similar implant stability quotient readings during the study period, the osteotome expansion technique showed significant improvement in secondary stability. The healing patterns for these techniques are therefore inconsistent.
关于使用骨扩张技术植入的下颌种植体的稳定性和骨整合的临床决策存在冲突且有限。目的是评估在12周期间,根据下颌后牙区无牙嵴的初始宽度选择的两种手术技术植入的种植体的稳定性,骨密度为D级。对33例患者的58枚种植体进行了评估。24例患者中的32枚种植体采用骨凿扩张技术植入,17例患者中的26枚种植体采用传统钻孔技术植入。在术后第0、1、2、3、4、6、8、10和12周记录种植体稳定性商值,并使用方差分析、独立样本和配对t检验进行评估。根据直径3.3mm种植体的稳定性读数进行校准,骨凿扩张组的骨密度低于传统组(64.96±6.25对68.98±5.06,P = 0.011)。与传统技术相比,骨凿扩张组实现了相当的初始稳定性(ISQ,P = 0.124),并且二级稳定性增加更大(ISQ,P = 0.07)。轻度水平缺损的D级牙槽嵴可通过骨凿扩张技术进行扩张。尽管两组在研究期间的种植体稳定性商读数相似,但骨凿扩张技术在二级稳定性方面显示出显著改善。因此,这些技术的愈合模式不一致。