正畸微种植体稳定性的临床共振频率分析

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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。 OBJECTIVE: To evaluate the clinical changes of stability of orthodontic micro-implants by using resonance frequency analysis and to explore the influence of appropriate loading timing and loading on the stability of micro-implants. Methods: Fourteen patients with orthodontic maxillary first premolar degeneration and requiring strong support were divided into two groups: delayed loading group and elective loading group. Each patient was implanted into the buccal alveolar bone area of ​​the maxillary posterior teeth with one piece of split micro-implants. The Osstell implant stability measuring instrument was used to analyze the resonance frequency. The micro-implants were recorded immediately and weekly Implant stability quotients (ISQ values). Deferred Loading Group Before the 150 g horizontal traction force was applied at Week 12, the time point at which ISQ values ​​were stable was chosen as the loading time for the Elective Loading group, with the same amount of orthodontic force applied. Two groups of patients were followed up to 16 weeks, using SPSS 19.0 package data analysis of variance and t test. Results: Of the 28 micro-implants, 5 were loosened within 4 weeks and the remaining 23 remained stable within 16 weeks. Resonance frequency analysis of 12 delayed-loaded micro-implants showed that ISQ values Immediately and the first week of the highest (21.48 ± 5.25), the second week to the fifth week decreased gradually after the first 6 weeks (11.26 ± 3.36). Eleven elective loading micro-implants loaded traction at week 6. From the sixth week to the 16th week, no significant changes were found in the ISQ values ​​of the two groups of micro-implants regardless of whether they were loaded or not. There was no significant difference between the two groups (P> 0.05). The initial ISQ values ​​of loose micro-implants were significantly smaller than those of non-loose ones. Conclusion: The stability of micro-implants decreased after 1 week and stabilized after 6 weeks. After 6 weeks of loading orthodontic force has no effect on the stability, and the poor initial stability is an important reason for the failure of micro-implants.
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