Norton Michael R
Int J Oral Maxillofac Implants. 2017 Jul/Aug;32(4):849-857. doi: 10.11607/jomi.5889.
The purpose of this study was to evaluate the impact of low insertion torque on primary stability and the short-term clinical outcome of single-tooth implants placed into healed ridges and fresh extraction sockets.
A cohort of n = 30 implants was self-selected on the basis that their insertion torque measured ≤ 20 Ncm. The cohort was closed with the follow-up set at 1 year. Resonance frequency analysis was evaluated in both mesiodistal (MD) and buccolingual (BL) directions at the time of implant insertion and at the time of restoration. Immediate temporization was determined by the esthetic need and a minimum implant stability quotient (ISQ) reading of 55. Implants were definitively restored after approximately 3 months. Implant survival was recorded along with changes in the level of the marginal bone relative to a fixed reference point, at the 1-year follow-up.
Twenty-two patients with a total of 30 implants were grouped by insertion torques of < 5 Ncm (spinners), > 5 < 10 Ncm, 10 Ncm, 15 Ncm, and 20 Ncm. One implant was excluded because follow-up data were unavailable. Of the remaining 29 implants, the mean ISQ measured 67 (MD) and 65 (BL) at surgery. The values increased to 80 (MD) and 79 (BL) after a period of 3 months. The survival rate at the end of the 1-year period was 96.7%, including the excluded implant, but 100% for the remaining 29 implants. The frequency of implants demonstrating no marginal bone loss was 71.4%, 0.1 to 0.5 mm bone loss was 21.4%, and bone loss > 0.5 mm (max = 2.82 mm) was only 7.2%. No implants were lost during the functional loading period. Data on immediate temporization revealed no significant difference in ISQ or marginal bone loss values for implants in this group.
Lower insertion torques yield favorable survival rates with optimal marginal bone levels compared with the accepted norm.
本研究的目的是评估低植入扭矩对植入已愈合牙槽嵴和新鲜拔牙窝的单颗牙种植体的初期稳定性及短期临床结果的影响。
根据植入扭矩测量值≤20 Ncm自行选择了一组n = 30颗种植体。该队列进行为期1年的随访。在种植体植入时和修复时，在近远中（MD）和颊舌（BL）方向进行共振频率分析。根据美学需求和种植体稳定性商数（ISQ）读数至少为55来确定即刻临时修复。大约3个月后对种植体进行最终修复。在1年随访时记录种植体的存留情况以及相对于固定参考点的边缘骨水平变化。
22例患者共30颗种植体，根据植入扭矩分为<5 Ncm（旋转者）、>5<10 Ncm、10 Ncm、15 Ncm和20 Ncm组。由于无法获得随访数据，排除了1颗种植体。在其余29颗种植体中，手术时平均ISQ在MD方向为67，在BL方向为65。3个月后，这些值分别增加到80（MD）和79（BL）。1年期末的存留率为96.7%（包括排除的种植体），但其余29颗种植体的存留率为100%。边缘骨无吸收的种植体频率为71.4%，骨吸收0.1至0.5 mm的为21.4%，骨吸收>0.5 mm（最大为2.82 mm）的仅为7.2%。在功能加载期无种植体丢失。即刻临时修复的数据显示，该组种植体的ISQ或边缘骨吸收值无显著差异。
与公认的标准相比，较低的植入扭矩可产生良好的存留率和最佳的边缘骨水平。
