Rokn Amir Reza, Labibzadeh Akram, Ghohroudi Amir Alireza Rasouli, Shamshiri Ahmad Reza, Solhjoo Somaye
Dental Implant Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Open Dent J. 2018 Jan 31;12:46-52. doi: 10.2174/1874210601812010046. eCollection 2018.
A correct diagnosis and optimal treatment planning is essential for success in implant dentistry. Proper diagnosis of bone quality is an important part of the diagnostic procedure.
The purpose of this study was to correlate the tactile sense of the surgeon in the assessment of bone density to the histomorphometric analysis of bone quality.
In this study, 56 bone samples from 33 patients were harvested from implant sites with trephine drills. The samples were analyzed with Image J software. In the samples following parameters were measured: BV/TV, superficial cortical plate thickness, the number and thickness of haversian canals in cortical bone and the number, thickness and distance of trabecules in cancellous bone. The clinical hardness of bone during drilling was evaluated by surgeon according to Misch. GEE analysis with exchangeable correlation structure and linear model was used to evaluate the relationship between the tactile sense of the surgeon and histomorphometric parameters and all analysis was adjusted for two confounding variables: gender and location.
There were 51.79% implants in D2 samples and 48.21% in D3. Bone classification according to Misch was significantly correlated to distance of trabecules in cancellous bone (-value=0.05), and shown marginally significant correlation with mean superficial cortical bone thickness (-value =0.07) and number of haversian canals (-value =0.005) in cortical bone.
There were differences between our results and others. The authors believed that these differences mainly are because of confounding factors, that in this study were eliminated. The clinical finding during surgery can approximately explain the histologic properties of bone.
It is concluded that tactile sense of the surgeon can exhibit the histologic properties of the bone, and we are able to estimate the healing prognosis of the bone in implant placement.
正确的诊断和最佳的治疗计划对于种植牙科的成功至关重要。对骨质量进行正确诊断是诊断过程的重要组成部分。
本研究的目的是将外科医生在评估骨密度时的触觉与骨质量的组织形态计量学分析相关联。
在本研究中,使用环钻从33名患者的种植部位采集了56块骨样本。使用Image J软件对样本进行分析。在样本中测量以下参数:骨体积分数(BV/TV)、表面皮质板厚度、皮质骨中哈弗斯管的数量和厚度以及松质骨中小梁的数量、厚度和间距。外科医生根据米施(Misch)的方法评估钻孔过程中骨的临床硬度。使用具有可交换相关结构和线性模型的广义估计方程(GEE)分析来评估外科医生的触觉与组织形态计量学参数之间的关系,并且所有分析都针对两个混杂变量进行了调整:性别和位置。
D2样本中的种植体占51.79%,D3样本中的占48.21%。根据米施的方法进行的骨分类与松质骨中小梁的间距显著相关(P值=0.05),并且与皮质骨的平均表面皮质骨厚度(P值 =0.07)和哈弗斯管数量(P值 =0.005)呈边缘显著相关。
我们的结果与其他研究结果存在差异。作者认为这些差异主要是由于混杂因素造成的,而在本研究中这些因素已被消除。手术中的临床发现可以大致解释骨的组织学特性。
得出结论,外科医生的触觉可以展现骨的组织学特性,并且我们能够估计种植体植入时骨的愈合预后。