正畸微种植体稳定性的临床共振频率分析

上海口腔医学 ›› 2014, Vol. 23 ›› Issue (5): 614-618.

正畸微种植体稳定性的临床共振频率分析

范莉, 缪喆, 唐国华

上海交通大学医学院附属第九人民医院·口腔医学院口腔正畸科,上海市口腔医学重点实验室,上海 200011

收稿日期:2014-03-11 修回日期:2014-04-22 出版日期:2014-10-20 发布日期:2015-02-04
通讯作者: 唐国华,021-23271699-5206,E-mail:drtanggh@gmail.com
作者简介:范莉(1970-),女,学士,副主任医师,E-mail:flyy0319@gmail.com

A clinical evaluation on the stability of orthodontic mini-implants using resonance frequency analysis

FAN Li, MIAO Zhe, TANG Guo-hua

Department of Orthodontics, Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2014-03-11 Revised:2014-04-22 Online:2014-10-20 Published:2015-02-04

摘要/Abstract

摘要： 目的用共振频率分析法评价正畸微种植体稳定性的临床变化规律,探讨合适的加载时机及加载对微种植体稳定性的影响。方法选择上颌第一前磨牙减数并需要强支抗的正畸患者14例,分为延期加载组和择期加载组各7例。每例患者在上颌后牙左右颊侧牙槽骨区植入分体式微种植体各1颗,用Osstell种植体稳定性测量仪作共振频率分析,植入后即刻及每周记录微种植体的种植体稳定性系数（implant stability quotients,ISQ值）。延期加载组在第12周加载150 g水平牵引力之前,选出ISQ值稳定的时间点,以此作为择期加载组的加载时机,施加同样大小的正畸力。2组患者均随访至16周,采用SPSS 19.0软件包对数据进行方差分析和t检验。结果 28颗微种植体中,5颗在4周内发生松动而取出,剩余23颗在16周内保持稳定,其中12颗延期加载组微种植体的共振频率分析显示,ISQ值在植入即刻及第1周最高（21.48±5.25）,第2周到第5周逐渐下降,第6周后维持平稳（11.26±3.36）。11颗择期加载组微种植体在第6周加载牵引力。从第6周至16周,2组微种植体无论加载与否, ISQ 值均无显著变化,2组间也无显著差异（P>0.05）。松动微种植体的初始ISQ值显著小于非松动组。结论微种植体植入1周后稳定性下降,6周后趋于稳定。6周后加载正畸力对稳定性无影响,而初始稳定性差是微种植体失败的重要原因。

关键词: 微种植支抗, 稳定性, 加载时机, 共振频率分析

Abstract: PURPOSE: To evaluate the stability of mini-implant by resonance frequency analysis and to determine the optimal loading timing of orthodontic force. METHODS: Fourteen orthodontic patients who had upper first premolars extraction and needed mini-implants to reinforce the anchorage were enrolled in this study. The patients were divided into 2 groups: delay-loading group and selective-loading group. A joined head mini-implant was inserted in the buccal interradicular area on each side of maxilla for each patient and 28 mini-implants in total were used. Osstell resonance frequency device was used to measure the ISQ (implant stability quotients) value. The measurements were performed immediately after the implant insertion and weekly afterwards until week 16. After the ISQ value was stable, orthodontic force of 150g was loaded on the mini-implants in selective-loading group. The same level of force was applied in delay-loading group at week 12. The data was analyzed by one-way ANOVA and t test using SPSS 19.0 software package. RESULTS: Twenty-three mini-implants were stable during the study. Twelve unloading mini-implants in delay-loading group showed maximal ISQ values immediately after insertion and at week 1 (21.48±5.25). The ISQ values decreased gradually from week 2 to week 5 and reached a plateau after week 6 (11.26±3.36). Eleven mini-implants survived in selective-loading group were then loaded at week 6. There were no significant differences of ISQ values in loading and unloading mini-implants after 6 weeks. The remaining 5 mini-implants were loosing during the first 4 weeks, which showed a significant lower initial ISQ values compared to the successful implants. CONCLUSIONS: The stability of mini-implants decreases 1 week after insertion and maintains after 6 weeks. Orthodontic loading after week 6 has no influence on the stability. Lower initial stability is an important factor for the failure of mini-implants.

Key words: Mini-implant, Stability, Loading time, Resonance frequency analysis

范莉, 缪喆, 唐国华. 正畸微种植体稳定性的临床共振频率分析[J]. 上海口腔医学, 2014, 23(5): 614-618.

FAN Li, MIAO Zhe, TANG Guo-hua. A clinical evaluation on the stability of orthodontic mini-implants using resonance frequency analysis[J]. Shanghai Journal of Stomatology, 2014, 23(5): 614-618.

参考文献

[1] Wu TY, Kuang SH, Wu CH. Factors associated with the stability of mini-implants for orthodontic anchorage: a study of 414 samples in Taiwan[J]. J Oral Maxillofac Surg, 2009, 67(8): 1595-1599.
[2] Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic mini-screw implants: a meta-analysis [J]. Am J Orthod Dentofacial Orthop, 2012, 142(5): 577-595.
[3] Poggio PM, Incorvati C, Velo S, et al. "Safe zones": a guide for miniscrew positioning in the maxillary and mandibular arch [J]. Angle Orthod, 2006, 76(2): 191-197.
[4] Kyung HM, Park HS, Bae SM. Development of orthodontic micro-implants for intraoral anchorage[J]. J CIin Orthod, 2003, 37(6): 321-328.
[5] Deguchi T, Takano-Yamamoto T, Kanomi R, et al. The use of small titanium screws for orthodontic anchorage [J]. J Dent Res, 2003, 82(5): 377-381.
[6] Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis[J]. Clin Oral Implants Res,1996,7(3):261-267.
[7] Nienkemper M, Wilmes B, Panayotidis A, et al. Measurement of mini-implant stability using resonance frequency analysis [J].Angle Orthod, 2013, 83(2): 230-238.
[8] Wu J, Bai YX, Wang BK. Biomechanical and histomorphometric characterizations of osseointegration during mini-screw healing in rabbit tibiae [J]. Angle Orthod, 2009, 79(3): 558-563.
[9] 亢静, 周洪, 安晓莉. 不同加载时机对微种植体稳定性影响的生物学研究 [J]. 实用口腔医学杂志, 2008, 24(2): 205-208.
[10] Deguehi D, Yamamoto TT, Kanomi R, et al. The use of small titanium screws for orthodontic anchorage[J]. J Dent Res, 2003, 82(6): 377-381.
[11] Roberts WE, Helm FR, Marshall KJ, et al. Rigid endosseous implants for orthodontic and orthopedic anchorage [J]. Angle Orthod, 1998, 59(4): 247-256.
[12] Luzi C, Verna C, Melsen B. Immediate loading of orthodontic mini-implants: a histomorphometric evaluation of tissue reaction [J]. Eur J Orthod, 2009, 31(1): 21-29.
[13] 吴丽萍, 徐婧秋. 微种植体支抗即刻和早期加载的电镜观察[J]. 同济大学学报(医学版), 2009, 30(4): 54-57.
[14] 陈岩, 赵文婷, Hee-Moon Kyung. 即刻负载对正畸微种植体的影响 [J]. 现代口腔医学杂志, 2008,13(1): 1-3.
[15] 姜晓红, 张扬, 韩雪, 等. 不同加载条件下的微螺钉支抗种植体骨界面的组织学观察 [J]. 上海口腔医学, 2008, 17(6): 621-624.
[16] Alliot B, Piotrowsk B, Marin P, et al. Regeneration procedures in immediate transmucosal implants: an animal study [J]. Int J Oral Maxillofac Implants, 1999, 14(16): 841-848.
[17] Chin MY, Sandham A, de Vries J, et al. Biofilm formation on surface characterized micro-implants for skeletal anchorage in orthodontics [J]. Biomaterials, 2007, 28(11): 2032-2040.