Koshy Ashwin Thomas, Mathew T Aby, Mathew Nicholas, Joseph Angel Mary
Department of Prosthodontics and Crown and Bridges and Implantology, Pushpagiri College of Dental Sciences, Thiruvalla, Pathanamthitta, Kerala, India.
J Indian Prosthodont Soc. 2017 Jan-Mar;17(1):74-79. doi: 10.4103/0972-4052.176530.
To assess the implant stability during different stages of healing in an immediate loaded implant soon after extraction. A 73-year-old female came with a chief complaint of bad smell and irritation in her lower front gum region. On examination, she was found to be completely edentulous in the maxillary arch and partially edentulous in the mandibular arch with only the canines present bilaterally. The posterior mandibular ridge was severely resorbed and hence could not be treated with a conventional mandibular complete denture. Considering the age of the patient and the preference of only a single surgical visit, we decided to plan for a conventional maxillary denture against an implant supported mandibular overdenture with two implants placed immediately after extraction of canines. The stability of these implants was assessed during the early phases of healing with the help of a resonance frequency analysis method (RFA) using Osstell ISQ. During the healing phase, implant stability quotient (ISQ) values decrease by 4-5 values after installation with the lowest values at the 1 week postplacement. Following this, the ISQ values increased steadily for all implants up to 16 weeks. No significant differences were noted over time. At placement, the mean ISQ values at 33 and 43 regions were 74 and 75.2, respectively. The mean lowest ISQ values recorded at the 1 week were 58.8 and 65.4, respectively. At 16 weeks, the mean ISQ values were 70.5 and 67.9, respectively. The survival of such immediately placed implants, which are later used as overdenture supported implants, are highly predictable when the surgical and prosthetic part is done meticulously. However, there needs future studies oriented to understand better the healing pattern of immediately placed implants in extraction sockets, which would guide the clinician with the optimal loading time.
评估拔牙后即刻负重种植体在愈合不同阶段的种植体稳定性。一名73岁女性因下颌前牙区牙龈有异味和不适感前来就诊。检查发现,她上颌牙弓完全无牙,下颌牙弓部分无牙,双侧仅存尖牙。下颌后牙区牙槽嵴严重吸收,因此无法使用传统下颌全口义齿进行治疗。考虑到患者年龄以及希望只进行一次手术的意愿,我们决定计划制作传统上颌义齿,并在拔除尖牙后即刻植入两颗种植体来支持下颌覆盖义齿。借助使用Osstell ISQ的共振频率分析方法(RFA),在愈合早期评估这些种植体的稳定性。在愈合阶段,种植体稳定性商数(ISQ)值在植入后下降4 - 5个值,在植入后1周时达到最低值。此后,所有种植体的ISQ值持续稳定上升直至16周。随时间推移未发现显著差异。植入时,33区和43区的平均ISQ值分别为74和75.2。在第1周记录的平均最低ISQ值分别为58.8和65.4。在16周时,平均ISQ值分别为70.5和67.9。当手术和修复部分精心完成时,这种即刻植入的种植体后期用作覆盖义齿支持种植体时,其存留率具有高度可预测性。然而,未来需要开展研究以更好地了解拔牙窝内即刻植入种植体的愈合模式,这将为临床医生提供最佳加载时间的指导。