【摘要】：目的利用動物實驗研究熱刺激微創(chuàng)取出骨結(jié)合牙種植體的條件,建立微創(chuàng)取出骨結(jié)合牙種植體動物模型,為臨床微創(chuàng)取出廢用牙種植體研究奠定基礎(chǔ)。方法研究分為三個部分:一、建立骨結(jié)合的牙種植體動物模型:選用5只1-2歲雜種犬為實驗動物,拔除兩側(cè)下頜第三或第四前磨牙,兩個月后常規(guī)種入牙種植體,三個月后經(jīng)臨床及放射學(xué)檢查,確定骨結(jié)合形成;二、研究熱刺激取出骨整合牙種植體條件:5只骨結(jié)合牙種植體動物模型,隨機選取右側(cè)為實驗側(cè),組成實驗組,分別以48±1℃持續(xù)1min(簡稱A因素)、53±1℃持續(xù)2.5min(B)、59±1℃持續(xù)3.5min(C)刺激實驗側(cè)種植體,于每次熱刺激前及刺激后4周測量種植體穩(wěn)定性系數(shù)(implant stability quotient,ISQ),改良菌斑指數(shù)(modified plaque index,mPLI),探診的深度(probing depth,PD),觀察影像學(xué)表現(xiàn)以及能否用扭矩扳手(≥35Ncm)取出種植體,左側(cè)為對照側(cè),組成對照組,不施加任何熱刺激,測量項目同實驗組。實驗結(jié)束后隨機選取一只實驗動物取雙側(cè)下頜骨標(biāo)本,觀察比較雙側(cè)骨結(jié)合變化情況;三、熱刺激法與傳統(tǒng)取骨環(huán)鉆法取出骨結(jié)合牙種植體牙槽骨骨量變化比較:右側(cè)以熱刺激法去除種植體,左側(cè)同期以取骨環(huán)鉆法去除種植體,然后測量植體取出術(shù)前、術(shù)后兩個月、術(shù)后三個月雙側(cè)牙槽骨骨量變化(寬度、高度),采取SPSS22.0統(tǒng)計軟件對實驗數(shù)據(jù)進(jìn)行統(tǒng)計分析,比較雙側(cè)牙槽骨骨量的變化。結(jié)果成功建立了熱刺激微創(chuàng)取出骨結(jié)合牙種植體動物模型:A、B因素刺激前和刺激后4周,實驗側(cè)與對照側(cè)相比,ISQ、mPLI,PD無顯著性差異,放射影像學(xué)檢查無明顯變化,無法用扭矩扳手取出種植體。C因素刺激后4周同對照側(cè)相比,實驗組ISQ明顯降低,差異具有顯著性(P0.05),放射影像學(xué)檢查顯示種植體周圍出現(xiàn)線形低密度影,但mPLI,PD雙側(cè)沒有顯著性差異(P0.05),實驗組采用50Ncm的力量可以取出種植體,對照組無法取出,病理結(jié)果示該條件下實驗側(cè)種植體表面出現(xiàn)有限骨質(zhì)吸收破壞。在種植體取出術(shù)之后兩個月,下頜雙側(cè)牙槽骨基本愈合,同取出術(shù)前相比,實驗組牙槽嵴寬度和高度未見顯著性變化(P0.05)。取出術(shù)后三個月實驗側(cè)牙槽嵴寬度和高度無顯著性變化(P0.05),對照側(cè)牙槽嵴寬度和高度下降明顯(P0.05)。取出術(shù)后三個月及術(shù)后兩個月,牙槽嵴高度組內(nèi)比較差別沒有顯著性(P0.05)。結(jié)論動物實驗顯示,已完成骨結(jié)合的牙種植體在59±1℃持續(xù)3.5min熱刺激條件下可使其周圍骨質(zhì)出現(xiàn)有限破壞,從而破壞其骨結(jié)合,而周圍軟組織無明顯損傷,達(dá)到微創(chuàng)取出種植體的目的,成功建立了熱刺激取出骨結(jié)合牙種植體動物模型,為進(jìn)一步研究臨床廢用牙種植體的微創(chuàng)取出提供參考。
[Abstract]:Objective to study the condition of minimally invasive extraction of bone and dental implants by thermal stimulation, and to establish the animal model of minimally invasive bone extraction combined with dental implants, so as to lay a foundation for the study of clinical minimally invasive extraction of waste dental implants. Methods the study was divided into three parts: first, the animal model of dental implants combined with bone was established: 5 mongrel dogs aged 1-2 years were selected as experimental animals, the third or fourth premolars of bilateral mandible were extracted, and two months later, the dental implants were routinely planted. After three months, bone bonding was confirmed by clinical and radiologic examination. Secondly, the condition of bone integration dental implant extraction by thermal stimulation was studied, and 5 animal models of osseous conjunctive dental implants were randomly selected as the experimental side to form an experimental group. The experimental implants were stimulated with 48 鹵1 鈩，

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