口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (1): 2-10.DOI: 10.12016/j.issn.2096-1456.2021.01.001
许竞()
收稿日期:
2020-03-05
修回日期:
2020-06-20
出版日期:
2021-01-20
发布日期:
2020-11-18
通讯作者:
许竞
作者简介:
许竞,主任医师,硕士,Email: Received:
2020-03-05
Revised:
2020-06-20
Online:
2021-01-20
Published:
2020-11-18
Contact:
Jing XU
摘要:
通过文献复习,梳理明确种植初期稳定性的性质、意义、测试、参数以及影响因素。种植初期稳定性即种植体-骨界面的锚固力,是一种纯粹的机械现象,其意义在于维持种植体静立不动状态,使新骨不受干扰地生长附着在种植体表面,避免纤维组织生长,最终达到骨整合。临床比较常见的初期稳定性测试方法有植入扭力(insertion torque,IT)、共振频率分析(resonance frequency analysis,RFA)的种植体稳定指数(implant stability quotient,ISQ)、叩诊试验Periotest等,以IT值更为常用,直接以IT值代替初期稳定性。目前未能就预示骨整合的初期稳定性具体参数标准形成统一认识,各个数值段初期稳定性的种植均有可能达到骨整合,但过高的初期稳定性有形成界面骨质微骨折导致骨坏死进而种植失败的可能。影响初期稳定性的因素有种植体的设计、牙槽骨骨质条件以及手术技巧三个方面。临床上在初期稳定性欠佳的情况下,即刻种植仍有获得成功骨整合的可能,需要重新审视现有测量初期稳定性手段的准确性,这直接关联临床是否能够选择正确合适的种植治疗路径。
许竞. 种植初期稳定性的意义及其参数标准[J]. 口腔疾病防治, 2021, 29(1): 2-10.
XU Jing. The significance and parameter standards of the implant primary stability[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2021, 29(1): 2-10.
图1 右上切牙根尖囊肿感染合并腭侧多生埋伏牙手术拔除即刻种植
Figure 1 Surgical removal of the upper right incisor radicular cyst with infection combined with palatal embedding of the supernumerary tooth and immediate implantation a: before surgery, 12 and 11 are residual crowns complicated by gingival fistula (arrow show); b: palatally embedded supernumerary tooth; c: sockets of 12 and 11; d: palatal wall of the socket of 12 is a penetrating defect (arrow show); e: labial wall of the socket of 11 is a penetrating defect (arrow show); f: the implants are anchored and the bone graft is transplanted, the implants are short of primary stability; g: the gingiva is replaced and sutured, the implants are half unsubmerged; h: 2 weeks after implantation; i: one year after implantation; j: labial side 4 years after implantation; k: palatal side 4 years after implantation
图2 右上切牙根尖囊肿慢性感染合并腭侧多生埋伏牙手术拔除即刻种植患者的术前术后影像学资料
Figure 2 Preoperative and postoperative imaging data of patients with chronic infection of a radicular cyst of the right upper incisor combined with palatal embedded supernumerary tooth surgical removal and immediate implantation a: panoramic images showing the cyst before surgery (arrow show); b: panoramic image after surgery; c: panoramic image one year after surgery; d: panoramic image 4 years after surgery; e: horizontal CT image of radicular cyst before surgery (arrow show); f: sagittal CT image of 11 and palatal supernumerary tooth before surgery, palatal bone is the penetrating defect (arrow show); g: sagittal CT image of 12 and radicular cyst before surgery, labial bone is the penetrating defect (arrow show); h: horizontal CT image after surgery; i: CT image of 11 in the sagittal position after surgery; j: CT image of 12 in the sagittal position after surgery; k: CT image in the horizontal position one year after surgery; l: CT image of 11 in the sagittal position one year after surgery; m: CT image of 12 in the sagittal position one year after surgery; n: CT image in the horizontal position 4 years after surgery; o: CT image of 11 in the sagittal position 4 years after surgery;p: CT image of 12 in the sagittal position 4 years after surgery
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