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超大直径种植体钻孔对种植体存活率和稳定性的影响:一项随机临床试验。

Evaluation of Oversized Drilling on Implant Survival and Stability Versus Traditional Drilling Technique: A Randomized Clinical Trial.

出版信息

Int J Oral Maxillofac Implants. 2021 Jul-Aug;36(4):771-778. doi: 10.11607/jomi.8777.

Abstract

PURPOSE

This study aimed to investigate the influence of oversized drilling on the stability of the implant and the bone response during osseointegration.

MATERIALS AND METHODS

The trial was designed as a prospective, parallel-group randomized controlled clinical trial with 20 implants placed in the posterior region of the maxilla. The sample size was divided into two groups, 10 each, with implants being placed with manufacturer-recommended implant osteotomy preparation according to the manufacturer guidelines in one group (MR group) vs oversized osteotomy preparation (3 to 5 mm) in the other group (oversized drilling [OD] group). The implant stability was monitored for 3 months by means of resonance frequency analysis, while the crestal bone levels were recorded using parallel technique periapical radiography for 6 months. Patient-reported outcomes including pain, swelling, satisfaction, and implant survival were all monitored throughout the study.

RESULTS

In the MR group, a mean decrease in implant stability quotient (ISQ) values was detected during the first 4 weeks, after which a gradual increase in values was recorded. In comparison, the OD group showed a rapid increase in ISQ value over the entire follow-up period from baseline and up to week 12. Regarding crestal bone level, follow-up showed a significant difference when comparing baseline and 6-month radiographs (P = .00) between the OD group, 0.908 mm ± 0.343, and the MR group, 1.3 ± 0.23 mm.

CONCLUSION

Within the limitations of this study, the results suggest that the oversized osteotomy technique may lead to earlier implant stability and postsurgical recovery compared with the manufacturer-recommended technique for osteotomy preparation. However, further studies are needed to confirm these findings.

摘要

目的

本研究旨在探讨过大直径钻孔对种植体稳定性和骨整合过程中骨反应的影响。

材料与方法

该试验设计为一项前瞻性、平行组随机对照临床试验,共在上颌后区植入 20 枚种植体。根据制造商指南,将样本量分为两组,每组 10 枚,一组采用制造商推荐的种植体骨切开术准备(MR 组),另一组采用过大直径骨切开术准备(OD 组,3 至 5mm)。通过共振频率分析监测种植体稳定性 3 个月,使用平行技术根尖片在 6 个月内记录颊侧骨吸收水平。在整个研究过程中监测患者报告的结果,包括疼痛、肿胀、满意度和种植体存活率。

结果

在 MR 组中,在第 4 周前检测到种植体稳定性系数(ISQ)值的平均下降,之后记录到值的逐渐增加。相比之下,OD 组在整个随访期间从基线到第 12 周的 ISQ 值快速增加。关于颊侧骨吸收水平,在 OD 组,0.908mm±0.343 和 MR 组,1.3±0.23mm,在第 6 个月的影像学检查中与基线相比,发现了显著差异(P=0.00)。

结论

在本研究的限制范围内,结果表明,与制造商推荐的骨切开术准备相比,过大直径骨切开术技术可能会导致更早的种植体稳定性和术后恢复。然而,需要进一步的研究来证实这些发现。

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