渐进性负载对种植体骨结合影响效果评价  

Effect of Progressive Loading on Peri-implant Osseointegration

作　　者：李家鹤 魏凌飞 曾妮 柳忠豪 LI Jiahe;WEI Lingfei;ZENG Ni;LIU Zhonghao(School of Stomatology,Binzhou Medical University,Yantai 264000,China;Department of Implantology,Yantai Stomatological Hospital,Binzhou Medical University,Yantai 264000,China)

机构地区：[1]滨州医学院口腔医学院,山东烟台264000 [2]滨州医学院附属烟台口腔医院种植科,山东烟台264000

出　　处：《口腔医学研究》2025年第2期147-154,共8页Journal of Oral Science Research

基　　金：国家自然科学基金(编号:82100965);山东省自然科学基金(编号:ZR2020QH162)。

摘　　要：目的:通过动物实验研究渐进性负载对种植体骨结合及边缘骨水平的影响。方法:选择6只雄性比格犬,每侧下颌种植3枚种植体并随机分为即刻负载、渐进性负载、不负载3组;不负载组和即刻负载组种植术后分别使用2.5 mm和7.0 mm愈合基台,并在整个实验期间不更换基台高度;渐进性负载组种植术后使用2.5 mm基台并在种植体植入后2周、4周、6周通过改变种植体愈合基台高度(3.5 mm、5.5 mm、7.0 mm)对种植体渐进性加载,术后0周,4周,6周,8周测量种植体周边缘骨水平,术后8周取种植体骨标本拍摄Micro-CT制作硬组织切片,观察种植体周新骨生成情况,并行种植体周骨体积分数(bone volume/total volume,BV/TV)、骨表面积分数(bone surface/bone volume,BS/BV)、骨小梁厚度(trabecular thickness,Tb.Th)、骨小梁数量(trabecular number,Tb.N)及骨小梁间隔(trabecular separation,Tb.Sp)及种植体骨结合率(BIC)测量。结果:共植入36枚种植体,仅即刻负载组1枚脱落,总体生存率97.2%。边缘骨水平稳定,Micro-CT骨显微参数无差异。硬组织切片显示活跃新骨生成,渐进性和即刻负载组BIC值高于不负载组,差异统计学显著。结论:在延期种植下,种植体植入颌骨后行渐进性负载能形成良好骨结合,骨结合效果优于不负载组。Objective:To investigate the effect of progressive loading on implant osseointegration and marginal bone levels through animal experiment.Methods:Six male beagle dogs were selected,with three implants placed on each side of the mandibles and randomly allocated to immediate loading,progressive loading,and non-loading groups.The non-loading and immediate-loading groups used 2.5 mm and 7.0 mm healing abutments after implant surgery,respectively,and did not change the abutment height during the experiment.The progressive-loading group used a 2.5 mm abutment after implant surgery and loaded the implants by changing the height of the implant-healing abutment(3.5 mm,5.5 mm,and 7.0 mm)at 2,4,and 6 weeks after implant placement.The marginal bone levels peri-implant at 0,4,6,and 8 weeks following surgery were measured.At eight weeks,bone specimens were obtained for measurements of bone volume/total volume(BV/TV),bone surface/bone volume(BS/BV),trabecular thickness(Tb.Th),trabecular number(Tb.N),trabecular separation(Tb.Sp),and BIC,as well as for Micro-CT analysis and hard tissue sections to look for new bone growth surrounding the implants.Results:A total of 36 implants were inserted,with only one failure in the immediate loading group,resulting in an overall survival rate of 97.2%.Marginal bone levels remained stable,with no significant changes in Micro-CT bone parameters.Active new bone production was seen in hard tissue sections,and the progressive and immediate loading groups'BIC values were significantly greater than those of the non-loaded group.Conclusion:In delayed implantation scenarios,progressive loading post-implantation promotes superior osseointegration compared to non-loading,leading to better bone integration results.

关 键 词：渐进性负载 骨改建 骨显微结构分析 种植体骨结合率 

分 类 号：R65[医药卫生—外科学]