渐进性负载对种植体骨结合影响效果评价

doi:10.13701/j.cnki.kqyxyj.2025.02.011

摘要/Abstract

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。

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。

Abstract: 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.

Key words: progressive loading, bone remodeling, bone microstructure analysis, BIC

李家鹤, 魏凌飞, 曾妮, 柳忠豪. 渐进性负载对种植体骨结合影响效果评价[J]. 口腔医学研究, 2025, 41(2): 147-154.

LI Jiahe, WEI Lingfei, ZENG Ni, LIU Zhonghao. Effect of Progressive Loading on Peri-implant Osseointegration[J]. Journal of Oral Science Research, 2025, 41(2): 147-154.

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