Goh Rayner, Li Kai Chun, Atieh Momen A, Ma Sunyoung, Oliver Abigail, Giraldo Diana, Tawse-Smith Andrew
Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, UAE.
Clin Implant Dent Relat Res. 2025 Feb;27(1):e13409. doi: 10.1111/cid.13409. Epub 2024 Nov 6.
Implantoplasty can be performed on implants diagnosed with peri-implantitis to facilitate implant decontamination and improve access for oral home care. However, its effect on the mechanical strength of the implant is still uncertain. This study aimed to evaluate the effect of implantoplasty on the fracture resistance of dental implants with various degrees of bone loss, as well as its surface changes.
Eighty 4.2 × 13 mm conical connection dental implants were allocated evenly into four groups based on the bone defect morphology: circumferential or semi-circumferential, and 3 or 5 mm vertical height. Half of the implants underwent implantoplasty with tungsten carbide finishing burs. Weight, volume, and surface roughness of the implants were recorded prior to and after instrumentation. All implants were subjected to static loading to failure or fracture and the implant surfaces were then analyzed using optical microscopy. Finite element analysis was carried out to assess the stress pattern on dental implants after implantoplasty.
Implantoplasty significantly reduced the fracture resistance of implants with all defect morphologies, aside from those with 3 mm of circumferential bone loss. Implants with 5 mm of peri-implant bone loss also experienced significantly reduced fracture resistance compared to the 3 mm group. Significant decrease in fracture resistance was only observed between the circumferential and semi-circumferential groups with 5 mm of bone loss. Surface roughness was also significantly reduced following implantoplasty. The results from finite element analysis revealed a change in pattern of stress concentration in the implant after implantoplasty.
Implantoplasty negatively impacted the fracture resistance of standard diameter dental implants in most scenarios. The increase in exposed implant length resulted in a decrease in fracture resistance. This increase in fracture risk should be considered prior to implantoplasty, especially in implants with more advanced bone loss.
对于诊断为种植体周围炎的种植体可进行种植体修整术，以利于种植体去污并改善口腔家庭护理的可达性。然而，其对种植体机械强度的影响仍不确定。本研究旨在评估种植体修整术对不同程度骨丧失的牙种植体抗折性的影响及其表面变化。
将80颗4.2×13mm锥形连接牙种植体根据骨缺损形态均匀分为四组：环形或半环形，以及垂直高度为3或5mm。一半的种植体使用碳化钨修整车针进行种植体修整术。在器械操作前后记录种植体的重量、体积和表面粗糙度。所有种植体均承受静态加载直至失效或折断，然后使用光学显微镜分析种植体表面。进行有限元分析以评估种植体修整术后牙种植体上的应力模式。
除了环形骨丧失3mm的种植体之外，种植体修整术显著降低了所有缺损形态种植体的抗折性。与3mm组相比，种植体周围骨丧失5mm的种植体抗折性也显著降低。仅在骨丧失5mm的环形和半环形组之间观察到抗折性显著降低。种植体修整术后表面粗糙度也显著降低。有限元分析结果显示种植体修整术后种植体内应力集中模式发生了变化。
在大多数情况下，种植体修整术对标准直径牙种植体的抗折性有负面影响。种植体暴露长度的增加导致抗折性降低。在进行种植体修整术之前应考虑这种骨折风险的增加，尤其是在骨丧失更严重的种植体中。
