Meir Haya, Sebaoun Alon, Raz Perry, Levartovsky Shifra, Arieli Adi, Pilo Raphel, Dor Zafar, Beitlitum Ilan
Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Materials (Basel). 2022 Jun 13;15(12):4200. doi: 10.3390/ma15124200.
Malpositioned and broken implants are usually fully osseointegrated; hence, their removal, especially from the lower arch, can be very challenging. Implant removal techniques include reverse torque and trephination. Trephination is an invasive technique that can jeopardize vital structures, cause mandibular fatigue fractures, or lead to osteomyelitis. In this study, we aimed to assess the relationship between trephination depth and implant stability by recording implant stability quotient (ISQ) readings at varying trephination depths in vitro. Materials and methods: Forty-eight implants were inserted into dense synthetic polyurethane foam blocks as artificial bone. Primary implant stability was measured with a Penguin resonance frequency analysis (RFA) device. Implants of two designs with a diameter of 3.75 mm and a length of 13 or 8 mm were inserted. Twenty-four internal hexagon (IH) (Seven®) and twenty-four conical connection (CC) implants (C1®; MIS® Implants, Ltd., Misgav, Israel) were used. The primary implant stability was measured with the RFA device. Trephination was performed, and implant stability was recorded at depths of 0, 3, and 6 mm for the 8 mm implants and 0, 3, 6, 8, 10, and 11.5 mm for the 13 mm implants. Results: Linear regression revealed a significant relation between the trephination depth and the ISQ (F (1, 213) = 1113.192, p < 0.001, adjusted r2 = 0.839). The trephination depth significantly predicted the ISQ (β = −5.337, p < 0.001), and the ISQ decreased by −5.33 as the trephination depth increased by 1 mm. Conclusion: Implant stability reduction as measured using an RFA device during trephination may be a valuable guide to achieving safe reverse torque for implant removal. Further studies are needed to evaluate these data in clinical settings.
位置不当和破损的种植体通常已完全骨整合；因此，将其取出，尤其是从下颌牙弓取出，可能极具挑战性。种植体取出技术包括反向扭矩和环钻术。环钻术是一种侵入性技术，可能危及重要结构、导致下颌疲劳性骨折或引发骨髓炎。在本研究中，我们旨在通过在体外不同环钻深度记录种植体稳定性商数（ISQ）读数，来评估环钻深度与种植体稳定性之间的关系。材料与方法：将48枚种植体植入致密合成聚氨酯泡沫块作为人工骨。用企鹅共振频率分析（RFA）设备测量种植体的初始稳定性。植入两种直径为3.75 mm、长度为13 mm或8 mm的种植体。使用了24枚内六角（IH）（Seven®）种植体和24枚锥形连接（CC）种植体（C1®；MIS® Implants, Ltd., Misgav, 以色列）。用RFA设备测量种植体的初始稳定性。进行环钻术，并记录8 mm种植体在0、3和6 mm深度以及13 mm种植体在0、3、6、8、10和11.5 mm深度时的种植体稳定性。结果：线性回归显示环钻深度与ISQ之间存在显著关系（F (1, 213) = 1113.192, p < 0.001, 调整后r2 = 0.839）。环钻深度显著预测了ISQ（β = −5.337, p < 0.001），且随着环钻深度每增加1 mm，ISQ下降−5.33。结论：在环钻术期间使用RFA设备测量的种植体稳定性降低，可能是实现安全反向扭矩以取出种植体的有价值指导。需要进一步研究以在临床环境中评估这些数据。
