植入扭矩對牙種植體骨結合影響的動物實驗研究
發(fā)布時間：2018-09-08 18:54
【摘要】：一、目的： 研究植入扭矩對牙種植體骨結合的影響,探索種植體最佳的植入扭矩值范圍,為臨床種植體植入提供可靠的科學理論依據(jù),提高種植手術的成功率。 二、方法： 1.實驗動物模型制備 選取全身發(fā)育良好的健康雄性成年Beagle犬6只,隨機編號為1～8號。所有實驗動物委托中山大學醫(yī)學實驗動物中心飼養(yǎng)。適應性飼養(yǎng)一周后,微創(chuàng)拔除雙側(cè)下頜第1、2、3、4前磨牙和第1磨牙。 2.種植體植入 拔牙創(chuàng)愈合3個月后,行種植體植入。每只實驗犬雙側(cè)下頜各植入XIVE種植體4枚,6只實驗犬共植入種植體48枚。種植體的規(guī)格均為3.4/9.5mm。所有的種植體均采用埋入式愈合。 3.植入扭矩的測量及分組 記錄種植體完全就位時的植入扭矩值,并以此作為該種植體的最大植入扭矩值(insertion torque value, ITV)。 根據(jù)種植體植入時的最大植入扭矩值將種植體分為四組：A組12枚,0NcmITV20Ncm;B組12枚,20Ncm≤ITV40Ncm;C組12枚,40Ncm≤ITV60Ncm;D組12枚,ITV≥60Ncm。 4.共振頻率分析的測量 在種植體完全就位后,立即使用共振頻率分析儀(RFA),測量種植體的穩(wěn)定性系數(shù)ISQ。分別測量種植體近中、舌側(cè)、遠中、頰側(cè)的ISQ值。每一枚種植體的每一個方向均測量三次,記錄平均值。無負重無干擾愈合三個月后,再次測量每枚種植體的近中、遠中、頰側(cè)和舌側(cè)ISQ值。 5.順序性熒光標記 種植體植入后的第2周、第4、周第8周和第12周順序性肌注熒光標記物鹽酸四環(huán)素(Tetracycline hydrochloride,TC,黃色)、鈣黃綠素(Calcein Green, CG,綠色)、茜素紅(Alizarin-complen, AE,紅色)、二甲酚橙(Xylend,X0,橘色)。通過測量熒光帶之間的垂直距離,計算礦化沉積率,比較各植入扭矩組新骨形成的速率。 6.組織學觀察和測量骨結合率 種植體植入3各月后制作超硬組織切片,亞甲基藍-酸性品紅染色,光鏡下觀察種植體-骨結合界面的組織學形態(tài)結構,比較各植入扭矩組種植體骨結合界面組織學上的異同,同時測量種植體骨結合率。 三、結果： 1.大體觀察 六只實驗比格犬均無死亡,飲食、活動正常。48顆種植體在植入三個月內(nèi),傷口愈合良好,種植體生長良好,無種植體松動脫落,無種植體周感染。 2.植入扭矩值測量與ISQ值測量 TV與ISQ(植入時)之間的相關系數(shù)r為0.494,P0.001,可以認為ITV與ISQ之間有統(tǒng)計學意義,因此在本研究中ITV與ISQ二者存在直線相關關系。 對A、B、C、D四組進行單因素方差分析,A組與B組P0.05,A組與C組P0.05,A組與D組P0.05,B組、C組、D組之間P0.05。以P=0.05為檢驗水準,認為A組與B組、C組、D組之間存在統(tǒng)計學差異,而B組、C組、D組之間無統(tǒng)計學差異。 種植體植入3個月后,A、B、C、D四組進行單因素方差分析,A組、B組、C組、D組各組之間P0.05。以P=0.05為檢驗水準,認為A組、B組、C組、D組之間ISQ值差異無統(tǒng)計學意義。 3.活體順序性熒光標記 在熒光顯微鏡下可見大量清晰的的兩種不同顏色熒光帶,呈片狀、網(wǎng)狀或條線狀,黃綠色為鈣黃綠素,紅色為茜素紅,紅色熒光帶位于黃綠色熒光帶內(nèi)側(cè)。計算各組礦化沉積率值,進行單因素方差分析,其中C組與A組、B組、D組之間礦化沉積率值差異存在統(tǒng)計學意義,而A組、B組和D組之間不存在統(tǒng)計學差異,本實驗認為C組礦化沉積率由于其他三組。 4.定量組織學分析 在光學顯微鏡下觀察亞甲基藍-酸性品紅染色后種植體骨結合界面清晰,成骨細胞及細胞核、類骨質(zhì)顯示清楚,成骨細胞核染成藍色,細胞基質(zhì)染成淡藍色。新生骨組織為深紅色,與種植體骨界面分界清晰,原礦化骨為紅色,但與新生骨分界比較模糊。B組、C組種植體骨結合率和骨面積百分數(shù)值與A組、D組之間存在統(tǒng)計學意義,B組和C組種植體與周圍骨組織結合的程度高于A組和D組。 四、結論： 1.本實驗認為植入扭矩值與ISQ之間存在正相關關系。在種植體植入時,植入扭矩值越大,其ISQ值也越大。當種植體植入時的最大植入扭矩值不小于20Ncm時,種植體均能取得良好的初期穩(wěn)定性。 2.最大植入扭矩值為40Ncm到60Ncm的種植體,其骨組織界面處的新骨形成速度比植入扭矩值低40Ncm和高于60Ncm的種植體更快； 3.當種植體的最大植入扭矩值為20Ncm到60Ncm之間時,種植體與周圍骨組織骨性結合程度高于植入扭矩值低于20Ncm和大于60Ncm的種植體。
[Abstract]:I. purpose:
To study the effect of implant torque on the osseointegration of dental implants, and to explore the optimal range of implant torque, so as to provide a reliable scientific basis for clinical implant implantation and improve the success rate of implant surgery.
Two, methods:
1. preparation of experimental animal models
Six healthy adult Beagle dogs were selected and randomly numbered 1-8. All the experimental animals were fed by the Medical Laboratory Animal Center of Sun Yat-sen University.
2. implant placement
Three months after the extraction wound healed, implants were implanted. Four XIVE implants were implanted in each dog's bilateral mandible and 48 implants were implanted in six dogs. The implants were all 3.4/9.5mm in size.
3. measurement and grouping of implant torque
The maximum insertion torque value (ITV) of the implant was recorded when the implant was fully in place.
According to the maximum implant torque, the implants were divided into four groups: 12 in group A, 0 Ncm ITV 20 Ncm; 12 in group B, 20 Ncm < ITV 40 Ncm; 12 in group C, 40 Ncm < ITV 60 Ncm; 12 in group D, ITV < 60 Ncm.
4. measurement of resonance frequency analysis
Immediately after the implant was fully in place, the stability factor ISQ of the implant was measured with a resonance frequency analyzer (RFA). The ISQ values of the near, lingual, distal, and buccal sides of the implant were measured respectively. Each implant was measured three times in each direction and the mean value was recorded. ISQ values in the middle, far, buccal and lingual side.
5. sequential fluorescence labeling
Tetracycline hydrochloride (TC, yellow), Calcein Green (CG, green), Alizarin-complen (AE, red), xylenol orange (Xylend, X0, orange) were sequentially injected at weeks 2, 4, 8 and 12 after implantation. The rate of mineralization was compared and the rate of new bone formation in each group was compared.
6. histological observation and measurement of osseointegration rate
Three months after implantation, superhard tissue sections were made and stained with methylene Blue-Acid fuchsin. The histological morphology of the implant-bone interface was observed under light microscope. The histological differences of the implant-bone interface between the implant torque groups were compared and the implant-bone binding rate was measured.
Three, results:
1. general observation
None of the six beagles died, had a normal diet and had normal movement. Forty-eight implants healed well within three months after implantation, the implants grew well, no implant loosening and no peri-implant infection occurred.
2. measurement of implant torque and measurement of ISQ value
The correlation coefficient between TV and ISQ (implantation time) was 0.494, P 0.001. It can be considered that there is statistical significance between ITV and ISQ, so there is a linear correlation between ITV and ISQ in this study.
A, B, C, D four groups were analyzed by one-way ANOVA. A group and B group P 0.05, A group and C group P 0.05, A group and D group P 0.05, B group, C group, D group P = 0.05 as the test level, it is considered that there are statistical differences between A group and B group, C group, D group, but there is no statistical difference between B group, C group and D group.
Three months after implantation, univariate analysis of variance was performed in group A, B, C and D. There was no significant difference in ISQ among group A, group B, group C and group D.
3. in vivo sequential fluorescent labeling
Under the fluorescence microscope, a large number of clear fluorescent bands of two different colors, flake, reticulate or linear, yellow-green for calcein, red for Alizarin red, red fluorescent band located in the inside of yellow-green fluorescent band. The difference of mineralization sedimentation rate between group A, group B and group D was statistically significant, but there was no statistical difference between group A, group B and group D.
4. quantitative histological analysis
After staining with methylene Blue-Acid fuchsin under optical microscope, the implant bone interface was clear, osteoblasts and nuclei were clearly displayed, osteoblast nuclei were stained blue, and cell matrix was stained light blue. The boundaries were blurred in group B. There was statistical significance between group C and group A and group D. The degree of implant-bone bonding in group B and group C was higher than that in group A and group D.
Four, conclusion:
1. There is a positive correlation between the implant torque and ISQ. The greater the implant torque, the greater the ISQ. When the maximum implant torque is not less than 20 Ncm, the implant can achieve good initial stability.
2. The implants with the maximum implant torque ranging from 40 Ncm to 60 Ncm were able to form new bone faster at the interface of bone tissue than those with the implant torque of 40 Ncm lower or more than 60 Ncm.
3. When the maximum implant torque is between 20Ncm and 60Ncm, the degree of osseointegration between the implant and the surrounding bone tissue is higher than that between the implant torque and the implant with the maximum implant torque below 20Ncm and above 60Ncm.
【學位授予單位】：南方醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R783.6
本文編號：2231394
[Abstract]:I. purpose:
To study the effect of implant torque on the osseointegration of dental implants, and to explore the optimal range of implant torque, so as to provide a reliable scientific basis for clinical implant implantation and improve the success rate of implant surgery.
Two, methods:
1. preparation of experimental animal models
Six healthy adult Beagle dogs were selected and randomly numbered 1-8. All the experimental animals were fed by the Medical Laboratory Animal Center of Sun Yat-sen University.
2. implant placement
Three months after the extraction wound healed, implants were implanted. Four XIVE implants were implanted in each dog's bilateral mandible and 48 implants were implanted in six dogs. The implants were all 3.4/9.5mm in size.
3. measurement and grouping of implant torque
The maximum insertion torque value (ITV) of the implant was recorded when the implant was fully in place.
According to the maximum implant torque, the implants were divided into four groups: 12 in group A, 0 Ncm ITV 20 Ncm; 12 in group B, 20 Ncm < ITV 40 Ncm; 12 in group C, 40 Ncm < ITV 60 Ncm; 12 in group D, ITV < 60 Ncm.
4. measurement of resonance frequency analysis
Immediately after the implant was fully in place, the stability factor ISQ of the implant was measured with a resonance frequency analyzer (RFA). The ISQ values of the near, lingual, distal, and buccal sides of the implant were measured respectively. Each implant was measured three times in each direction and the mean value was recorded. ISQ values in the middle, far, buccal and lingual side.
5. sequential fluorescence labeling
Tetracycline hydrochloride (TC, yellow), Calcein Green (CG, green), Alizarin-complen (AE, red), xylenol orange (Xylend, X0, orange) were sequentially injected at weeks 2, 4, 8 and 12 after implantation. The rate of mineralization was compared and the rate of new bone formation in each group was compared.
6. histological observation and measurement of osseointegration rate
Three months after implantation, superhard tissue sections were made and stained with methylene Blue-Acid fuchsin. The histological morphology of the implant-bone interface was observed under light microscope. The histological differences of the implant-bone interface between the implant torque groups were compared and the implant-bone binding rate was measured.
Three, results:
1. general observation
None of the six beagles died, had a normal diet and had normal movement. Forty-eight implants healed well within three months after implantation, the implants grew well, no implant loosening and no peri-implant infection occurred.
2. measurement of implant torque and measurement of ISQ value
The correlation coefficient between TV and ISQ (implantation time) was 0.494, P 0.001. It can be considered that there is statistical significance between ITV and ISQ, so there is a linear correlation between ITV and ISQ in this study.
A, B, C, D four groups were analyzed by one-way ANOVA. A group and B group P 0.05, A group and C group P 0.05, A group and D group P 0.05, B group, C group, D group P = 0.05 as the test level, it is considered that there are statistical differences between A group and B group, C group, D group, but there is no statistical difference between B group, C group and D group.
Three months after implantation, univariate analysis of variance was performed in group A, B, C and D. There was no significant difference in ISQ among group A, group B, group C and group D.
3. in vivo sequential fluorescent labeling
Under the fluorescence microscope, a large number of clear fluorescent bands of two different colors, flake, reticulate or linear, yellow-green for calcein, red for Alizarin red, red fluorescent band located in the inside of yellow-green fluorescent band. The difference of mineralization sedimentation rate between group A, group B and group D was statistically significant, but there was no statistical difference between group A, group B and group D.
4. quantitative histological analysis
After staining with methylene Blue-Acid fuchsin under optical microscope, the implant bone interface was clear, osteoblasts and nuclei were clearly displayed, osteoblast nuclei were stained blue, and cell matrix was stained light blue. The boundaries were blurred in group B. There was statistical significance between group C and group A and group D. The degree of implant-bone bonding in group B and group C was higher than that in group A and group D.
Four, conclusion:
1. There is a positive correlation between the implant torque and ISQ. The greater the implant torque, the greater the ISQ. When the maximum implant torque is not less than 20 Ncm, the implant can achieve good initial stability.
2. The implants with the maximum implant torque ranging from 40 Ncm to 60 Ncm were able to form new bone faster at the interface of bone tissue than those with the implant torque of 40 Ncm lower or more than 60 Ncm.
3. When the maximum implant torque is between 20Ncm and 60Ncm, the degree of osseointegration between the implant and the surrounding bone tissue is higher than that between the implant torque and the implant with the maximum implant torque below 20Ncm and above 60Ncm.
【學位授予單位】：南方醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R783.6
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