热损伤在牙种植体拔除中的应用研究  

Application of Thermal Damage in Osseointegrated Implant Extraction

作　　者：王淼 徐博雅 朱秀峰 常晓峰 贺龙龙[1,2,3] WANG Miao;XU Boya;ZHU Xiufeng;CHANG Xiaofeng;HE Longlong(Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China;Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China;Department of Implant Dentistry,College of Stomatology,Xi'an 710004,Shaanxi,China;Department of Digital Implant Restoration,College of Stomatology,Xi'an Jiaotong,Xi'an 710004,Shaanxi,China)

机构地区：[1]陕西省颅颌面精准医学研究重点实验室,陕西西安710004 [2]陕西省牙颌疾病临床研究中心,陕西西安710004 [3]西安交通大学口腔医院种植科,陕西西安710004 [4]西安交通大学口腔医院数字化种植修复科,陕西西安710004

出　　处：《中国美容医学》2025年第2期19-23,共5页Chinese Journal of Aesthetic Medicine

基　　金：西安市创新能力强基计划-医学研究项目(名称:早期短时低强度热刺激对牙种植体骨结合影响的实验研究;编号:22YXYJ0097)。

摘　　要：目的:通过加热种植体有控制地破坏牙种植体的骨结合状态,使已经形成骨结合但无保留意义的种植体能够以较小的扭矩旋出,从而微创拔除种植体。方法:在离体组织中,使用加热器在新鲜牛肋骨-种植体模型上寻找理想的加热温度和加热时间。在动物实验中,观察加热种植体后种植体旋出扭矩、种植体稳定性和种植体周围骨组织学变化。根据离体组织结果将动物实验分为四组。包括:空白对照组;C1组(低温组),100℃持续30 s;C2组(高温组1),200℃持续20 s;C3组(高温组2),300℃持续20 s。结果:动物实验结果表明低温组C1加热后1周ISQ值和旋出扭矩均有所增加,拔除1个月后骨表面可见。高温组C2、C3加热后1周ISQ值和旋出扭矩均下降,且拔除种植体后1个月C2组在骨表面可观察到少量新生骨线的形成,但是C3组未见新生骨线。实验结果提示C2组的温度设置在加热种植体后可以降低种植体旋出扭矩且不影响周围骨的再生。结论:热处理是微创拔除种植体的可行方法之一,但应注意加热温度及加热时间。Objective To use heating to disrupt the bone-implant interface of dental implants,allowing for the minimally invasive removal of implants that are no longer needed but have formed stable osseointegration.Methods In vitro experiments were conducted using a fresh bovine rib-implant model to determine the ideal heating temperature and duration using a heating device.In vivo experiments were then carried out to observe the effects of implant heating on implant stability,removal torque,and histological changes in the surrounding bone tissue.The in vivo experiments were divided into four groups based on the results of the in vitro experiments:a blank control group,C1(low-temperature group):100℃for 30 s,C2(high-temperature group 1):200℃for 20 s,and C3(high-temperature group 2):300℃for 20 s.Results The in vivo experiments showed that the low-temperature group(C1)had an increase in implant stability and removal torque one week after heating,and bone growth was observed on the implant surface one month after removal.The high-temperature groups(C2 and C3)had a decrease in implant stability and removal torque one week after heating,and while bone growth was observed on the implant surface of the C2 group one month after removal,no bone growth was observed in the C3 group.The results suggest that C2 group can reduce implant removal torque without affecting bone regeneration.Conclusion Thermal treatment can be used as a minimally invasive method for removing dental implants,but the temperature and duration of heating should be carefully considered.

关 键 词：牙种植体 热损伤 骨结合 拔除 微创 

分 类 号：R782.11[医药卫生—口腔医学]