旋入扭矩值与共振频率分析对种植体初期稳定性的相关性研究  

A correlation study of implant primary stability determination by means of insertion torque and resonance frequency analysis

作　　者：刘东 吴煜农[1] LIU Dong;WU Yunong(Department of Oral and Maxillofacial Surgery,Affiliated Stomatological Hospital of Nanjing Medical Universi-ty,Nanjing 210029,China)

机构地区：[1]南京医科大学附属口腔医院口腔颌面外科,江苏南京210029

出　　处：《口腔医学》2020年第5期426-431,共6页Stomatology

基　　金：国家自然科学基金(81772887);江苏省医学创新团队资助项目(CXTD2017036);江苏省高校优势学科建设工程(2018-87)。

摘　　要：目的通过旋入扭矩值(insertion torque value,ITV)与共振频率分析(resonance frequency analysis,RFA)评估种植体初期稳定性,研究ITV、ISQ值之间相关关系,进一步分析两指标相关影响因素。方法225例患者共植入449枚植体,术中记录ITV,植入后即刻行RFA测量得出种植体稳定系数(Implant stability quoient,ISQ)。根据患者年龄、性别、骨质质量、术区位置、植体长度、直径6个独立因素对种植体分组并统计相关指标。使用SPSS软件对数据进行统计分析。结果ITV和ISQ值总体间存在微弱的正相关关系(r=0.217,P<0.01),而在骨质质量较差的情况下两者表现出相对较高的相关性(r=0.54,P<0.01)。患者年龄、性别对种植体ITV及ISQ值均无影响。骨质密度越高,平均ITV越大,差异显著。而所有骨类组植体间ISQ值无差异。3.5 mm直径组植体平均ISQ值较4.3、5.0 mm直径组均低(P<0.05),而4.3、5.0 mm直径组间未见差异。各长度组间ITV及ISQ值均未见差异。下颌区植体平均ISQ值与ITV均高于上颌区,而后牙区植体仅ISQ值较前牙区高(P<0.05)。结论ITV和共振频率分析所得的ISQ值可作为评价种植体稳定性的两个不同特征,彼此相互独立。但在骨质质量较差的情况下,ITV可部分反映ISQ值的大小。在种植方式与植体一致情况下,ITV仅与骨质质量存在明显正性相关,而仅种植体直径与骨质质量一定程度上对ISQ值具有正性影响,有利于轴向稳定性的获得。最后,种植于下颌后牙区的植体在抗旋转或轴向稳定性方面均具有较好的早期稳定性。Objective To determine the primary stability measured by peak insertion torque value(ITV) and resonance frequency analysis(RFA) and to investigate the correlation between ITV and ISQ value and the related influential variables. Methods Four hundred and forty-nine dental implants were placed into 225 patients. ITV was recorded during surgery, and then implant stability quotient(ISQ) values were measured using wireless RFA. The implants were grouped according to 6 independent variables including age, sex, bone quality, surgical area, length and diameter of implants. Statistical analyses were performed with the SPSS software. Results Generally, a weak positive correlation was observed between ITV and ISQ values(r=0.217, P<0.01), while in the case of poor bone quality, the correlation between the two indexes was relatively high. No statically differences in terms of age, gender, implant length were found for ISQ and ITV. A higher level of statistical significance was found for ITV(P<0.01) when grouping implants by bone quality, while good ISQ values showed in most cases, especially in posterior sector of mandible. The mean ISQ value of 3.5 mm diameter group was statistically significant smaller than that of 4.3 and 5.0 mm group. The mandibular group had significantly higher mean ISQ and ITV values than the maxillary group, but significant difference was observed between the anterior and posterior sector only in ISQ values. Conclusion ITV and ISQ value can be taken as two independent features of primary stability. However, in the case of poor bone quality, ITV can partly reflect the ISQ value. Under the same conditions of implant protocol and implant body, ITV is only strongly correlated with the bone quality, while both diameter and bone quality seem to pose a positive effect on the measured ISQ to some extent. Implants in the posterior sector of the mandible tend to obtain better primary stability no matter in anti-rotation or axial stability.

关 键 词：初期稳定性 旋入扭矩值 共振频率分析 相关关系 影响因素 

分 类 号：R782.1[医药卫生—口腔医学]