| Objective:1.The purpose of this study was to analyze whether the low implant torque will affect the initial stability and secondary stability of the implant,due to the low tissue density in the early healing stage after tooth extraction,so as to explore the effect of the reconstruction of tooth extraction fossa on the osseointegration of the implant at this stage.2.To observe the short-term clinical effect of modified minimally invasive technique in the early stage of extraction socket healing in posterior teeth(8-12 weeks),compared with that of routine implant time(more than 24 weeks),and analyze its feasibility,so as to provide clinical reference for the design of early and modified flapless implant in posterior area.Methods:From January 2018 to June 2019,15 patients with missing posterior teeth were randomly selected from the Department of Implant of the affiliated Stomatological Hospital of Nanchang University from January 2018 to October 2019.15 patients with missing teeth for 8-12 weeks and 15 patients with missing teeth for more than 24 weeks were randomly divided into early minimally invasive implantation group(experimental group)and conventional minimally invasive implantation group(control group).There were 21 female patients and 9 male patients,ranging in age from 19 to 68 years(mean 38.77 ±14.82 years).A total of 30 implants were planned to be implanted in the early group(n=15)and the routine group(n=15).The implant systems are Dentium implant system in Korea and Straumann implant system in Switzerland.All the healing methods were transgingival healing with the installation of the healing abutment.All the operations were performed by the same senior implant doctor.The patients were asked to reexamine at 1 week,2 weeks,4 weeks and 12 weeks after operation.Permanent restoration was performed at 12 weeks after operation,and the superstructure of the single crown was repaired with screws.The related indexes were observed and recorded,including preoperative CBCT measurement of bone mineral density(Hu),implant retention rate,implant torque(Insertion Torque Value,ITV),implant resonance frequency analysis(Resonance frequency analysis,RFA),bone level of buccal margin of implant,width of buccal keratinized mucosa,length of operation,wound healing index and visual simulation score of postoperative pain.The data were analyzed by SPSS26.0 software.To compare the clinical effect of modified minimally invasive implant technique on single posterior tooth at different implantation time.There was significant difference between the two groups(P<0.05).Results:1.The immediate torque of the implant was on the low side,but the short-term observation of the implant survival rate was 100%.2.With the extension of time,imaging showed that the osseointegration of the implant was good,at the same time,there was no statistical difference in the amount of buccal marginal bone change and buccal keratinized gingival change,and the implant stability ISQ and plaque index increased,but there was no statistical difference.3.The post operative reaction of the patients was small,there was no obvious pain,the speed of wound healing was fast and the subjective satisfaction was high.Conclusion:1.In the early stage of tooth extraction fossa healing,low tissue density will lead to low initial stability of the implant,but does not affect the implant osseointegration.2.The application of modified mini-invasive technique in the early healing stage of posterior teeth not only has good clinical effect,but also has the advantages of simple operation,short operation time,small postoperative reaction and greatly improved comfort,so it is a feasible implant scheme.However,the long-term effect remains to be further observed. |
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