Gil Luiz Fernando, Sarendranath Alvin, Neiva Rodrigo, Marão Heloisa F, Tovar Nick, Bonfante Estevam A, Janal Malvin N, Castellano Arthur, Coelho Paulo G
Int J Oral Maxillofac Implants. 2017 Mar/Apr;32(2):329-336. doi: 10.11607/jomi.4802.
This study evaluated whether simplified drilling protocols would provide comparable histologic and histomorphometric results to conventional drilling protocols at a low rotational speed.
A total of 48 alumina-blasted and acid-etched Ti-6Al-4V implants with two diameters (3.75 and 4.2 mm, n = 24 per group) were bilaterally placed in the tibiae of 12 dogs, under a low-speed protocol (400 rpm). Within the same diameter group, half of the implants were inserted after a simplified drilling procedure (pilot drill + final diameter drill), and the other half were placed using the conventional drilling procedure. After 3 and 5 weeks, the animals were euthanized, and the retrieved bone-implant samples were subjected to nondecalcified histologic sectioning. Histomorphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) analysis were performed.
Histology showed that new bone was formed around implants, and inflammation or bone resorption was not evident for both groups. Histomorphometrically, when all independent variables were collapsed over drilling technique, no differences were detected for BIC and BAFO; when drilling technique was analyzed as a function of time, the conventional groups reached statistically higher BIC and BAFO at 3 weeks, but comparable values between techniques were observed at 5 weeks; 4.2-mm implants obtained statistically higher BAFO relative to 3.75-mm implants.
Based on the present methodology, the conventional technique improved bone formation at 3 weeks, and narrower implants were associated with less bone formation.
本研究评估了简化钻孔方案在低转速下是否能提供与传统钻孔方案相当的组织学和组织形态计量学结果。
总共48枚经过氧化铝喷砂和酸蚀处理的Ti-6Al-4V种植体,有两种直径(3.75和4.2毫米,每组n = 24),在低速方案(400转/分钟)下双侧植入12只犬的胫骨中。在相同直径组内,一半种植体在简化钻孔程序(导向钻+最终直径钻)后植入,另一半采用传统钻孔程序植入。3周和5周后,对动物实施安乐死,并对取出的骨-种植体样本进行不脱钙组织切片。进行组织形态学、骨与种植体接触(BIC)以及骨面积分数占有率(BAFO)分析。
组织学显示种植体周围形成了新骨,两组均未发现明显炎症或骨吸收。组织形态计量学方面,当所有自变量按钻孔技术合并时,未检测到BIC和BAFO有差异;当将钻孔技术作为时间的函数进行分析时,传统组在3周时BIC和BAFO在统计学上更高,但在5周时观察到两种技术的数值相当;相对于3.75毫米的种植体,4.2毫米的种植体在统计学上获得了更高的BAFO。
基于本方法,传统技术在3周时改善了骨形成,较窄的种植体与较少的骨形成相关。