种植初期稳定性的意义及其参数标准  

The significance and parameter standards of the implant primary stability

作　　者：许竞 XU Jing(Department of Oral and Maxillofacial Surgery,Stomatological Hospital,Southern Medical University,Guangzhou 510280,China)

机构地区：[1]南方医科大学口腔医院口腔颌面外科,广东广州510280

出　　处：《口腔疾病防治》2021年第1期1-10,共10页Journal of Prevention and Treatment for Stomatological Diseases

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 sta⁃bility 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。The nature,significance,parameters,influencing factors and testing of implant primary stability were studied by a literature review.Primary stability is a kind of anchorage force at the interface between the implant and bone,and it is merely mechanical.The significance of primary stability is to keep the implant unmovable so that the new bone can grow undisturbed on the surface of the implant without interference from fibrous tissue.The implant is fi⁃nally bound to the bone by osseointegration.The most common assessments of primary stability are insertion torque(IT),the implant stability quotient(ISQ)of the resonance frequency analysis(RFA)and Periotest.IT is more commonly used to directly imply initial stability.At present,no consensus has been reached regarding the concrete parameters of prima⁃ry stability to predict osseointegration.Implant osseointegration could be developed through all phases of primary stabili⁃ty.However,the excessive primary stability would cause mini⁃bone fractures,followed by bone necrosis at the interface and the final failure of implantation.Primary stability is influenced by three factors:implant design,bone condition of al⁃veolar bone,and surgical technique.Under the condition of a lack of primary stability and immediate implantation,there may be the possibility of successful osseointegration.Therefore,it is necessary to re⁃examine the accuracy of the current elaboration on the primary stability.It is related directly to whether the clinic can choose the appropriate im⁃plant treatment path.

关 键 词：牙种植 初期稳定性 植入扭力 骨整合 共振频率分析 叩诊试验 种植体稳定指数 主动初期稳定性 被动初期稳定性 

分 类 号：R78[医药卫生—口腔医学]