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在缺乏经验的外科医生中,使用引导式手术模板的低密度骨中,种植体设计对种植体稳定性的影响:使用共振频率分析的一项前瞻性随机对照临床试验。

The influence of implant design on implant stability in low-density bone under guided surgical template in inexperienced surgeons: A pilot randomized controlled clinical trial using resonance frequency analysis.

机构信息

Esthetic Restorative and Implant Dentistry Program, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

出版信息

Clin Implant Dent Relat Res. 2022 Aug;24(4):444-454. doi: 10.1111/cid.13100. Epub 2022 May 17.

Abstract

INTRODUCTION

There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact.

AIM

To investigate the implant stability in relation to two different implant designs, a cylindrical shaped single-threaded design (CS/ST) and a tapered shaped double-threaded design (TS/DT) using resonance frequency analysis over the first 8 weeks after implantation.

MATERIALS AND METHODS

Twenty-eight implants were randomly allocated using computer-generated random numbers into two groups and were placed as single tooth implant in the posterior arch in human jaw as specimens. iCAT™ CBCT scan (Hatfield, PA) was used to determine the bone density according to Misch's Bone classification. The osseotomy sites were prepared and implants were placed with guided surgical template by inexperienced surgeons which were prepared with the same implant planning software (3shape® implant studio). The implant stability was measured using the resonance frequency analysis Osstell® ISQ (Osstell AB, Sweden) on the implant level over the first 8 weeks at three different time intervals. A mean implant stability quotient (ISQ) value was recorded at each measurement time points. The first ISQ of each implant recorded at the time of implant placement were considered as baseline and were the so-called primary stability.

RESULTS

All 28 dental implants were analyzed. A similar pattern of implant stability changes was observed in both implant designs. A significant decreased was found at the first 4 weeks after implantation (p < 0.05) before ascending to maximum cumulative stability by the eighth week (p < 0.05). Between the two groups, TS/DT group had a higher mean ISQ values than that of the CS/ST group at all three observation periods but did not reach statistical significance (p = 0.69). Regarding different types of bone, TS/DT showed a significant difference in mean ISQ values in D4 bone. To date, all 28 implants are in function with no failure/and or complications.

CONCLUSIONS

The difference in implant design did not significantly influence the implant stability. TS/DT shows superiority over CS/ST when placed in D4 bone and offer a significant advantage due to their positive bounce back of the ISQ values by the eighth week after implant installation.

CLINICAL TRIAL REGISTRATION

TCTR20211020005.

摘要

引言

有几个因素极大地影响了种植体的稳定性,其中种植体设计是一个至关重要的因素;然而,很少有研究调查其影响。

目的

使用共振频率分析,在种植后 8 周内,研究两种不同种植体设计(圆柱形单螺纹设计[CS/ST]和锥形双螺纹设计[TS/DT])与种植体稳定性的关系。

材料和方法

使用计算机生成的随机数将 28 个种植体随机分配到两组,作为单个牙种植体植入人类下颌后弓作为标本。iCAT™ CBCT 扫描(宾夕法尼亚州 Hatfield)用于根据 Misch 的骨分类确定骨密度。经验不足的外科医生使用相同的种植体规划软件(3shape® implant studio)准备引导式手术模板,进行骨切开术。使用 Osstell® ISQ(Osstell AB,瑞典)在种植体水平上,在最初的 8 周内,在三个不同的时间间隔测量种植体稳定性。在每个测量时间点记录平均种植体稳定性商(ISQ)值。每个种植体在种植时记录的第一个 ISQ 被认为是基线,即所谓的初始稳定性。

结果

对所有 28 个牙种植体进行了分析。两种种植体设计均观察到相似的种植体稳定性变化模式。种植后第 4 周时,种植体稳定性显著下降(p < 0.05),第 8 周时达到最大累积稳定性(p < 0.05)。在两组之间,TS/DT 组在所有三个观察期的平均 ISQ 值均高于 CS/ST 组,但未达到统计学意义(p = 0.69)。对于不同类型的骨,TS/DT 在 D4 骨中的平均 ISQ 值有显著差异。迄今为止,所有 28 个种植体均在功能状态下,无失败/或并发症。

结论

种植体设计的差异对种植体稳定性没有显著影响。在 D4 骨中,TS/DT 优于 CS/ST,并且由于其在种植体植入后第 8 周时 ISQ 值的积极回弹,具有显著优势。

临床试验注册号

TCTR20211020005。

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