Straumann种植体骨愈合期稳定性变化的临床动态监测

目的：应用共振频率分析仪评估Straumann种植体植入后稳定性的变化以及影响种植体稳定性的相关因素。方法：28例牙齿缺失患者共植入35枚非潜入式Straumann种植体,在术中、术后1、2、3、4、6、8、12周对种植体的稳定性进行共振频率分析（RFA）,记录分析种植体稳定性数值（ISQ）。结果：种植体稳定性ISQ值的变化趋势表现为：术后前4周出现轻微波动,4～12周略有上升,经方差分析在各时间段的ISQ值无显著差异。骨密度和种植体长度对种植体稳定性有显著影响（P〈0.05）,种植体直径、性别和颌位对种植体ISQ值无明显影响。术后12周种植体的留存率均为100%。结论：种植体稳定性与种植体长度和骨质类型关系密切。共振频率分析（RFA）评估种植体稳定性是一种可靠有效的方法。     

正畸微种植体稳定性的临床共振频率分析

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。     

Osstell ISQTM监测种植体稳定性的临床研究

目的：分析种植体初期稳定系数（ISQi）与植入扭矩值（ITv）在评估初期稳定性中的关系;分析不同初期稳定性种植体在骨愈合期种植体稳定系数（ISQ）的变化趋势。方法：选择牙缺失患者34例,共55枚种植体。应用Osstell ISQTM共振频率分析仪于种植体植入时测量ISQ和记录ITv,并于植入后4周、8周、12周监测ISQ变化。结果： ISQi与ITv存在强正相关性。低初期稳定性组种植体植入后ISQ呈持续上升过程,高初期稳定性组ISQ则呈先降后升趋势,4周降至最低点。结论： Osstell ISQTM能良好评价和监测种植体稳定性, ISQi与ITv均为评价种植体初期稳定性的客观指标,种植体稳定性的变化趋势与初期稳定性范围相关。     

Straumann种植体早期稳定性相关因素的研究

目的：利用共振频率分析（resonance frequency analysis,RFA）仪器监测Straumann种植体骨愈合期的稳定性变化,并探讨其影响因素。方法：选择25例牙列缺损患者,共植入Straumann种植体52颗。用RFA仪器分别测量各种植体在种植术当天、术后1、4、6、8、12周的种植体稳定性（ISQ值）。将ISQ值进行通用线性模型的方差分析,采用Minitab软件包进行统计学处理。结果：所有种植体在植入时都取得了良好的初期稳定性。种植术后当天,ISQ平均值为64.39±0.66,术后呈现下降趋势,并在术后第4周下降至最低,而从第4周到第6周出现明显上升。统计学分析表明,种植区和牙槽骨对种植体ISQ值有显著影响（P〈0.05）,种植体长度、颈部高度对种植体ISQ值无明显影响。术后12周,种植体存活率为100%。结论：种植体稳定性与种植体区位置和牙槽骨类型关系密切,而种植体的长度和颈部高度的影响尚缺乏足够临床证据。     

亲水性大颗粒喷砂酸蚀表面种植体骨愈合期的共振频率分析及早期负荷临床探讨

目的:应用共振频率分析仪检测Straumann亲水性大颗粒喷砂酸蚀表面(SLActive)种植体骨愈合期内稳定性变化及种植体早期负荷临床探讨。方法:49例患者共计植入68颗Straumann SLActive种植体,分别在植入即刻、术后1、3、6、10、12周测量种植体稳定性,种植体稳定商值(ISQ)>65的种植体于术后6周早期负荷。结果:术后1周ISQ呈小幅增长,术后3周下降至最低,之后逐渐上升。经方差分析在术后12周时ISQ的增长具有显著性差异,其余时点无显著性差异。放射片显示种植体周围边缘骨吸收小于1 mm,术后12周时种植体留存率达100%。种植体颌位对ISQ有显著影响(P<0.05),种植体直径、长度对ISQ无显著影响。结论:Straumann SLAc-tive种植体早期负荷具有较高的临床可预期性,临床中可以显著缩短治疗周期,共振频率分析是监测种植体稳定性变化的有效手段。     

生骨片对后牙区种植体骨结合的影响

目的 通过共振频率分析仪测量种植体的稳定系数（ISQ）,以明确生骨片对后牙区种植体骨结合状况的影响。方法 选取48例患者共101颗DENTIUM种植体作为研究对象,其中对照组24例患者（50颗种植体）按种植术后常规处理;余24例患者（51颗种植体）作为处理组,在种植术后常规处理的基础上加服生骨片。于种植术后即刻,术后4、8、12周利用共振频率分析仪测量ISQ值,将2组患者所测得的ISQ值进行比较。结果 处理组上、下颌骨种植体于术后即刻、术后12周所测得的ISQ值与对照组相比,差异无统计学意义（P>0.05）;术后4、8周所测得的ISQ值优于对照组,差异有统计学意义（P<0.05）。处理组和对照组下颌骨种植体于术后即刻,术后4、8和12周所测得的ISQ值优于上颌骨种植体,差异均具有统计学意义（P<0.05）。结论 种植术后早期服用生骨片,有助于加快种植体骨结合,提高术后4、8周种植体的ISQ值,进而降低种植体-骨关键愈合阶段的脱落风险,保证种植术的成功率,提供临床修复的时机。     

上下颌后牙区单颗SLA和SLActive种植体共振频率分析比较

目的    应用共振频率分析法使用共振频率分析仪Osstell ISQ对比大颗粒喷砂酸蚀（SLA）和亲水性大颗粒喷砂酸蚀（SLActive）2种表面种植体的种植体稳定系数（ISQ）变化趋势,评价SLActive种植体临床预期性。方法    2011年1—9月就诊于广东省佛山市第二人民医院口腔修复中心的上下颌后牙区部分牙缺失患者55例,后牙区被植入33颗SLA种植体（SLA组）和34颗SLActive种植体（SLActive组）,对比测量术后即刻、2周、4周、6周、12周种植体稳定性。结果    2组对比ISQ在术后2、4、6及12周的变化差异均有统计学意义（均P＜0.05）,而术后即刻差异无统计学意义（P＞0.05）。结论      SLActive能促进骨结合,缩短愈合时间,增加临床预期性。     

膨体聚四氟乙烯钛加强膜结合纳米羟基磷灰石增加牙槽嵴垂直骨量后的种植体早期负重：2年前瞻性研究

目的：通过为期2年的前瞻性多中心研究,旨在评估牙槽嵴垂直骨增量术（verticalridgeaugmentation．VRA）后14周种植体修复负载后的成功率。材料和方法：在三家私人诊所选择20名患者,在拟种植区域实施VRA。富合镁的纳米羟基磷灰石（Mg-eHAP）作为唯一的骨充填材料,其表面覆盖钛加强型膨体聚四氟乙烯（e—PTFE）膜（Gore—Tex）．同时植入共计42枚粗糙表面的种植体。为了优化美学效果．以高2mm的愈合基台取代覆盖螺帽。3个月后行二期手术,术后2周．采用平台转换技术戴入最终修复体。修复负载后的第12个月、24个月测量牙槽嵴垂直骨增量、种植修复的成功率、并发症及X线种植体边缘骨水平变化。并应用共振频率分析技术测量种植体植入期（TO期）、最终修复体戴入期（T1期）和修复后24个月（T2期）三个时间点的种植体稳定性指数（implantstabiIityquotient．ISQ）。结果：整个研究过程全部患者无一人退出．植入的种植体均较稳固,修复体无一例失败。初期临床评估牙槽嵴垂直骨高度吸收平均为41mm,1例出现后期膜暴露。20例患者中有19例的全部植入骨获得骨再生,平均骨增高量为5.6mm。X线显示修复24个月后种植体间的平均骨再生量为1．0mm（s=0.48mm）,与修复12个月后的骨增量比较无明显差异。统计学显示随时间的推移种植体周围有明显骨丧失,修复时种植体周围骨丧失平均0．3mm,修复1年后骨丧失为0．90mm．2年后达到098mm。而ISQ值却随时间的推移明显上升,在种植体植入时ISQ均值为493．最终修复后是639,修复负重2年达到73．6。结论：本临床研究表明牙槽嵴垂直骨增量术中应用钛加强型膨体聚四氟乙烯膜结合纳米镁羟基磷灰石能够保证表面粗糙种植体的种植成功率．甚至在其早期负重病例中也能获得成功。     

Straumann种植体早期负荷与延迟负荷稳定性的比较研究

目的 通过RFA仪器监测,了解Straumann种植体在植入颌骨后骨愈合期间早期负荷与延迟负荷其稳定性的变化并分析其规律。方法 选择25例牙列缺损患者,共植入Straumann种植体52枚。患者随机分为实验组和对照组,实验组在术后第6周进行早期负荷,对照组在术后第12周进行延迟负荷。用RFA仪器分别测量各种植体在种植术当日、术后1周、4周、6周、8周、12周时代表稳定性的ISQ值。将两组ISQ值根据不同时间段进行比较分析并进行统计学检验。结果 所有种植体在植入时都取得了良好的初期稳定性,ISQ平均值为64.39±0.66。各组种植体稳定性在术后第4周下降至最低,而从第4周到第6周出现明显上升。统计学分析表明实验组和对照组的种植体的ISQ值在不同时间段间无统计学差异(P>0.05)。结论 早期负荷的种植体在不同骨愈合时期能取得良好的稳定性。在合理的计划和选择病人后,实施早期负荷不失为一个好的治疗手段。     

应用共振频率评估种植体稳定性的临床研究

目的：应用共振频率分析评估牙种植体初期稳定性和预测牙种植俸骨结合．为上颌窭提升植骨同期植入种植体和种植体早期暴露的临床应用提供客观依据方法：36个病人共植入87颗牙种植体，分为3组，A组种植体早期暴露组；B组上颌宴提升植骨同期种植组；C组常规种植组即对照组在种植体植入即刻、二期暴露或修复负重前测定种植体稳定性，每一颗种植体前后测定2次测定使用的仪器是共振频率分析仪Osstell，其数值单位是ISQ.结果：三组种植体初期稳定性数值范围是5492—80．20ISQ A组初期稳定性值最高，和其他两组之间的差异存在显著性.R组和C组之间差异没有统计学意义骨结合形成后稳定性范围在57．94—79．38ISq三组种植体的后期稳定性之间差异没有统计学意义.A组和B组初期稳定性和骨结合形成后的稳定性数值前后没有差异，C组前后稳定性差异有统计学意义.结论：共振频率分析牙种植体初期稳定性和预测骨结合是一种可靠而有效的方法，同时也提示种植体早期丞露和上颌宴提升植骨同期种植术对具有适应症的病例是可行的.     

Early loading of ITI implants supporting maxillary fixed full-arch prostheses

Objective: To evaluate the predictability of the early‐loaded sand‐blasted, large‐grit and acid‐etched (SLA) implants supporting maxillary‐fixed full‐arch prostheses. Material and methods: Ninety‐one ITI SLA implants were placed in 12 edentulous maxillae. The impressions were taken at 4 weeks post‐surgery. The abutments were tightened and the final fixed prostheses were cemented at 6 weeks after implant placement. Resonance frequency analysis (RFA) was conducted on the day of the surgery, at 4 and 6 weeks post‐surgery. Panoramic radiographs were taken immediately after surgery, at 4 weeks post‐surgery, immediately after prostheses attachment (baseline) and at the yearly follow‐ups. Results: The survival rate of implants was 98.90%. The success rate of prostheses was 100% during the follow‐ups. The radiographic result showed no radiolucency around the implants and the marginal bone level revealed no significant resorption compared with the baseline. The marginal bone level remained coronally beyond the first thread. The RFA results revealed Implant Stability Quotient (ISQ) values of 63.44±4.32, 57.14±4.25 and 66.43±3.78 for the three time points. Conclusions: The findings of this study indicated that early loading of ITI implants supporting maxillary fixed full‐arch prostheses should be predictable.     

密度不同的颌骨内单个种植体稳定性的测量观察

目的探讨颌骨不同密度单个种植体稳定性的变化规律，为早期负载提供依据。方法50例牙列缺损患者，共植入104枚ITI大颗粒酸蚀喷砂表面处理种植体，按种植区骨密度进行分组。在术中、术后1、4．6、8、12周进行共振频率分析，记录种植稳定值。结果骨密度对种植体初期稳定性有显著的影响（P〈0．001），Ⅰ类骨初期稳定性明显高于Ⅳ类骨，12周各组稳定性的差异无统计学意义。6周和12周稳定性比较，Ⅰ类骨和Ⅱ、Ⅲ类骨比较，差异无统计学意义（P〉0．05），与Ⅳ类骨比较，差异有统计学意义（P〈0．001）。结论Ⅰ、Ⅲ类骨种植体早期负载具有可行性。     

Ninety percent success in palatal implants loaded 1 week after placement: a clinical evaluation by resonance frequency analysis

To investigate the behaviour of early loaded palatal implants when observed with resonance frequency analysis (RFA). Twenty patients (seven males and 13 females, mean age 26.4 years) received one palatal implant each (length: 4 mm, diameter: 3.3 mm; Orthosystem) for maximum orthodontic anchorage. The implants' stability was observed by RFA. Measurements were carried out at the time of surgery, after first orthodontic loading and subsequently once a week over a period of 12 weeks. Two palatal implants were lost. The other 18 remained stable. The average period from insertion to first loading was 6.7+/-0.8 days. The mean orthodontic force applied was 272.2+/-73.2 cN. The implant stability quotient (ISQ) value at the time of surgery averaged 69.4+/-3.9. The mean ISQ value 6.7 days after insertion was 69.8+/-3.6. Twelve weeks post-surgery the mean ISQ value was 69.8+/-3.5. A statistically significant decrease in stability was observed after 2 and 3 weeks post-surgery (P=0.005 and 0.04). The behaviour of early loaded palatal implants showed an initial decrease of the ISQ values. From 6 weeks post-surgery onward the ISQ values increased. Within the limitations of this study, the results suggest that the healing time of palatal implants reported in the literature (12 weeks) should be discussed. An orthodontic loading of palatal implants 6 weeks post-surgery with a force up to 400 cN seems to be justified. Yet further investigations are necessary to evaluate the behaviour of early loaded palatal implants considering observation periods of over 12 weeks.     

Stability change of chemically modified sandblasted/acid-etched titanium palatal implants. A randomized-controlled clinical trial

Aim: The aim of this randomized-controlled clinical study was to examine stability changes of palatal implants with chemically modified sandblasted/acid-etched (modSLA) titanium surface compared with a standard SLA surface, during the early stages of bone healing.
Materials and methods: Forty adult volunteers were recruited and randomly assigned to the test group (modSLA surface) and to the control group (SLA surface). The test and control implants had the same microscopic and macroscopic topography, but differed in surface chemistry. To document implant stability changes resonance frequency analysis (RFA) was performed at implant insertion, at 7, 14, 21, 28, 35, 42, 49, 56, 70 and 84 days thereafter. RFA values were expressed as an implant stability quotient (ISQ).
Results: Immediately after implant installation, the ISQ values for both surfaces tested were not significantly different and yielded mean values of 73.8±5 for the control and 72.7±3.9 for the test surface. In the first 2 weeks after implant installation, both groups showed only small changes and thereafter a decreasing trend in the mean ISQ levels. In the test group, after 28 days a tendency towards increasing ISQ values was observed and 42 days after surgery the ISQ values corresponded to those after implant insertion. For the SLA-control group, the trend changed after 35 days and yielded ISQ values corresponding to the baseline after 63 days. After 12 weeks of observation, the test surface yielded significantly higher stability values of 77.8±1.9 compared with the control implants of 74.5±3.9, respectively.
Conclusion: The results support the potential for chemical modification of the SLA surface to positively influence the biologic process of osseointegration and to decrease the healing time.     

下颌无牙颌种植固定修复早期负载的临床观察

目的:评价下颌无牙颌种植固定修复早期负载的可行性和临床疗效。方法:14例下颌无牙颌病例共植入94颗ITISLA种植体,种植体植入后第6周完成固定修复。于植入当天、第4周、修复后1年行影像学检查,观察种植部位牙槽骨吸收情况。在植入即刻及第4周行共振频率分析。结果:种植体1年成功率为100%,修复体的1年成功率为100%。影像学检查示种植体周无低密度影;种植部位牙槽骨水平未见明显吸收,均位于种植体第一螺纹的冠方,从全景片测量得1年牙槽骨水平吸收为(0.3±0.94)mm。共振频率分析显示,植入即刻与第4周分别为69.54±4.29和63.14±5.57。结论:ITI SLA种植体固定修复下颌无牙颌早期负载是可行的。     

Factors influencing resonance frequency analysis assessed by Osstell™mentor during implant tissue integration: II. Implant surface modifications and implant diameter

Objectives: To monitor the development of the stability of Straumann^® tissue‐level implants during the early phases of healing by resonance frequency analysis (RFA) and to determine the influence of implant surface modification and diameter. Material and methods: A total of twenty‐five 10 mm length implants including 12 SLA RN ?4.1 mm implants, eight SLActive RN ?4.1 mm implants and five SLA WN ?4.8 mm implants were placed. Implant stability quotient (ISQ) values were determined with Osstell^?mentor at baseline, 4 days, 1, 2, 3, 4, 6, 8 and 12 weeks post‐surgery. ISQ values were compared between implant types using unpaired t‐tests and longitudinally within implant types using paired t‐tests. Results: During healing, ISQ decreased by 3–4 values after installation and reached the lowest values at 3 weeks. Following this, the ISQ values increased steadily for all implants and up to 12 weeks. No significant differences were noted over time. The longitudinal changes in the ISQ values showed the same patterns for SLA implants, SLActive implants and WB implants. At placement, the mean ISQ values were 72.6, 75.7 and 74.4, respectively. The mean lowest ISQ values, recorded at 3 weeks, were 69.9, 71.4 and 69.8, respectively. At 12 weeks, the mean ISQ values were 76.5, 78.8 and 77.8, respectively. The mean ISQ values at all observation periods did not differ significantly among the various types. Single ISQ values ranged from 55 to 84 during the entire healing period. Pocket probing depths of the implants ranged from 1 to 3 mm and bleeding on probing from 0 to 2 sites/implant post‐surgically. Conclusions: All ISQ values indicated the stability of Straumann^® implants over a 12‐week healing period. All implants showed a slight decrease after installation, with the lowest ISQ values being reached at 3 weeks. ISQ values were restored 8 weeks post‐surgically. It is recommended to monitor implant stability by RFA at 3 and 8 weeks post‐surgically. However, neither implant surface modifications (SLActive) nor implant diameter were revealed by RFA. To cite this article:
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell^?mentor during implant tissue integration: II. Implant surface modifications and implant diameter.
Clin. Oral Impl. Res. 21 , 2010; 605–611.
doi: 10.1111/j.1600‐0501.2009.01909.x     

Stability and marginal bone level measurements of unsplinted implants used for mandibular overdentures: a 1-year randomized prospective clinical study comparing early and conventional loading protocols

Objectives: The aim of this study was to compare the performance of two non‐splinted implants used as retention for a mandibular overdenture when applying conventional or early loading protocols. Material and methods: Twenty edentulous patients were treated with two unsplinted and non‐submerged implants (15 mm long, TiUnite RP, Brånemark System) in the anterior mandible. The patients were randomly allotted into two groups: (i) test group (Group A), in which the overdenture was connected 1 week after surgery, and (ii) control group (Group B), in which the overdenture was connected after 12 weeks of healing. Resonance frequency analyses (RFA) for implant stability measurements were performed at implant surgery and after 1, 3, 6, 9 and 12 months. Marginal bone levels were evaluated at implant surgery and after 6 and 12 months. Results: No implant from either group was lost and all implants showed less than 1 mm of marginal bone resorption during the first year. The mean implant stability quotient (ISQ) values at implant surgery were 76.2±2.8 for Group A and 75.6±4.5 for Group B. The 12‐month measurements showed 76.4±2.5 ISQ and 76.4±2.8 ISQ for Groups A and B, respectively. There were no statistically significant changes between or within the groups with time. There were no differences in marginal bone loss, which was on average 0.3 mm for both groups after 1 year. Conclusion: Although a limited number of patients were followed for 1 year only, the results of the present study indicate that early loading of two unsplinted 15 mm long implants with an overdenture does not negatively affect implant stability or marginal bone conditions when compared with implants subjected to 12 weeks of healing before loading.     

Resonance frequency analysis of one-stage dental implant stability during the osseointegration period

BACKGROUND: Currently, there is no available clinical tool to evaluate the amount of osseointegration and stability around dental implants. It has been recently suggested that changes in the stiffness of an implant in bone during healing may be monitored by using resonance frequency analysis (RFA). The aim of this study was to determine whether RFA can be integrated into the routine clinical evaluation of initial healing of dental implants. METHODS: Thirty-one patients (18 female and 13 male; mean age of 51.7 years) were included into this study. A total of 122 implants and three different, but comparable, implant designs were evaluated by using RFA. The specific transducer for each implant system was used. ISQ (implant stability quotient) readings were obtained for each implant at the time of surgery, 3 and 6 weeks postoperatively, and at the time of loading (3 or 6 months following surgery). Data were analyzed for different healing times, various anatomical locations, implant length, and type. Average time in function was 12 months. RESULTS: Two implants failed during healing. Implant stability was higher on the mandible compared to the maxilla for each implant system studied (Mann-Whitney test, P <0.01). ISQ readings decreased significantly at 3 and 6 weeks post-surgery compared to readings obtained at surgery (Wilcoxon matched pairs sign-rank tests, P <0.01). A recovery to the initial ISQ levels was noted at the time of implant loading. The possible effects of different types and lengths of implants to ISQ readings were examined. CONCLUSIONS: Results of this study support the need for a clinical tool to evaluate dental implant stability prior to loading, especially for implants placed in the maxilla. It appears that implant stability is weakest at 3 to 6 weeks in one-stage non-loaded dental implants. ISQ readings can be used to determine different healing phases and the stability of dental implants. However, it is difficult to define a general standardized range of ISQ readings for successful implant integration for various implant systems. Thus, RFA values/ISQ levels should be calibrated for each implant system separately. Further studies are needed to compare the early changes seen in immediately loaded dental implants and to determine whether there is any time in which the total recovery in ISQ levels may occur.