Assistant Professor, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY and Assistant Professor, Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY.
Graduate Student, PhD Program in Morphological Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; and Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
J Oral Maxillofac Surg. 2021 Feb;79(2):346-355. doi: 10.1016/j.joms.2020.09.041. Epub 2020 Oct 8.
The aim of the present study was to systematically analyze how a multifactorial surgical instrumentation approach affects osseointegration on both narrow-diameter and wide-diameter short implants.
Twelve skeletally mature female sheep were used in the study along with 144 plateau-root-form healing chamber titanium (Ti-6Al-4V) implants (Bicon LLC, Boston, MA), evenly distributed between narrow (3.5 mm) and wide (6.0 mm) diameters. The presence or the absence of irrigation, different drilling speeds, and 2 time points quantifying bone-implant contact (BIC) and bone area fraction occupancy (BAFO) to evaluate the osteogenic parameters around the implants.
There were no signs of inflammation, infection, or failure of the implants observed at either healing period. The narrow 3.5-mm implant, at 6 weeks, yielded significant differences in terms of BIC at a drilling speed of 50 rotations per minute (RPM), with higher values of the samples using irrigation (30.6 ± 6.1%) compared with those without (19.7 ± 6.1%). No statistical differences were detected for 500 and 1,000 RPM with or without irrigation. The wide 6-mm diameter implant showed differences with respect to drilling speed, 500 and 1,000 RPM, with higher values associated with samples subjected to irrigation. BAFO results, for both diameters, only detected statistical differences between the 2 times (3 vs 6 weeks); no statistical differences were detected when evaluating as a function of time, drilling speed, and irrigation.
Surgical instrumentation variables (ie, drilling speed [RPM] and irrigation) yielded to be more of an effect for BIC at longer healing time (6 weeks) for the wider implants. Furthermore, deploying narrow or wide plateau-root-form implants, where conditions allow, has shown to be a safe alternative, considering the high BIC and BAFO values observed, independent of irrigation.
本研究旨在系统分析多因素外科器械方法如何影响窄径和宽径短种植体的骨整合。
本研究使用 12 只骨骼成熟的雌性绵羊和 144 个高原根形愈合腔钛（Ti-6Al-4V）植入物（Bicon LLC，波士顿，MA），均匀分布在窄（3.5mm）和宽（6.0mm）直径之间。存在或不存在冲洗，不同的钻孔速度，以及 2 个时间点来量化骨-种植体接触（BIC）和骨面积占有率（BAFO），以评估种植体周围的成骨参数。
在任何愈合期都没有观察到炎症、感染或植入物失败的迹象。在 6 周时，窄 3.5mm 种植体在 50 转/分钟（RPM）的钻孔速度下，BIC 有显著差异，使用冲洗的样本值较高（30.6±6.1%）与未使用冲洗的样本值（19.7±6.1%）相比。无论是否冲洗，在 500 和 1000 RPM 下均未检测到统计学差异。宽 6mm 直径种植体在钻孔速度、500 和 1000 RPM 方面存在差异，与冲洗样本相比，值较高。对于两种直径，BAFO 结果仅在 2 个时间点（3 周与 6 周）之间检测到统计学差异；在评估时间、钻孔速度和冲洗作为函数时，未检测到统计学差异。
对于更宽的植入物，在更长的愈合时间（6 周）时，外科器械变量（即钻孔速度[RPM]和冲洗）对 BIC 的影响更大。此外，在条件允许的情况下，使用窄或宽的高原根形植入物是一种安全的替代方法，考虑到观察到的高 BIC 和 BAFO 值，与冲洗无关。
