Department of Prosthodontics, Saarland University, Kirrberger Strasse 100, 66421 Homburg / Saar, Germany.
J Oral Implantol. 2022 Dec 1;48(6):557-561. doi: 10.1563/aaid-joi-D-21-00135.
A novel implant system resembling the shape of a wedge and employing piezosurgery for implant bed preparation has been introduced with the aim of solving the problem of horizontal bone deficiency. This in vitro study compared emerging bone strain during insertion of a conventionally round implant vs the wedge implant. Adhering to the manufacturers' protocols, implant surgery was performed in polyurethane foam blocks equipped with strain gauges attached to the buccal and occlusal surfaces. Five implants per group were placed while strain development during insertion was recorded. Primary implant stability was determined using resonance frequency analysis. Statistical analysis was based on Welch's 2-sample tests (α = 0.05). In general, greater strain development was found on the buccal aspect of bone compared to the occlusal aspect with an overall range between -724 μm/m and 9132 μm/m. A stepwise increase in strain development was seen in the wedge implants while, in the round implants, a continuous increase in strain development was recorded. Absolute strain development on the buccal aspect of bone was significantly greater in wedge implants (P = .0137) while, on the occlusal aspect, significantly lower strain development was seen for wedge implants (P = .0012). Primary stability of wedge implants was significantly lower compared to round implants (P = .0005). Wedge implants differ from round implants with respect to the insertion process characterized by a stepwise increase in bone deformation. High strain development in buccal bone may constitute a risk factor for bone resorption and should be avoided by reducing the degree of underpreparation of the implant site.
一种类似于楔形的新型植入系统，采用超声骨刀进行种植床预备，旨在解决水平骨量不足的问题。本体外研究比较了传统圆形种植体与楔形种植体植入时的骨应变。按照制造商的方案，在装有颊面和颌面应变片的聚亚安酯泡沫块上进行种植体手术。每组 5 个种植体，记录植入过程中的应变发展情况。使用共振频率分析确定初始种植体稳定性。统计分析基于 Welch 2 样本检验（α=0.05）。一般来说，颊面的骨应变比颌面大，总体范围在-724 μm/m 到 9132 μm/m 之间。楔形种植体的应变发展呈逐步增加，而圆形种植体的应变发展呈连续增加。楔形种植体颊面的骨绝对应变发展明显大于圆形种植体（P=0.0137），而在颌面，楔形种植体的应变发展明显较低（P=0.0012）。与圆形种植体相比，楔形种植体的初始稳定性明显较低（P=0.0005）。楔形种植体与圆形种植体的植入过程不同，表现为骨变形的逐步增加。颊骨的高应变发展可能构成骨吸收的风险因素，应通过减少种植部位的预备不足程度来避免。
