| Purpose Oral implant is based on the preoperative evaluation of bone in the proposed planting area to develop the appropriate implantation treatment plan.With the rapid development and application of visualization technology in the field of oral implant,whether the bone mineral density in the implant area can be quantified has become the key for the operator to pursue accurate implant.Bone histomorphometry(BHMT)can quantify bone,which has always been called the "gold standard" for the evaluation of bone.The bone volume fraction(BV/TV)of the implant area can best reflect the change of bone mass in the bone microstructure.At present,there are few clinical studies on the bone microstructure of human jaw tissue.In this study,BHMT was used to quantify the bone mineral density as bone volume fraction in the implant area of patients with maxillary and mandibular posterior teeth,and the correlation between bone mineral density and various parameters of implant initial stability was analyzed,so as to explore the influence of bone mineral density on the initial stability of implants.Methods A total of 68 missing teeth(37 maxilla and 31 mandible)were performed in 57 patients with posterior dental implants in the Dental Center of our hospital from September 2018 to November 2019,including 32 patients of maxilla and 25 patients of mandible.During the operation,a circular bone drill with an inner diameter of 1.7mm,an outer diameter of 2.3mm and a length of 16 mm was used to remove the cylindrical bone at the implantation site.After fixation,decalcification,embedding and HE staining,the bone fragments were made into 4um thick sagittal tissue pathological sections,and then the bone mineral density was quantitatively analyzed by PANNORAMIC panoramic section scanning imaging technology combined with medical digital pathological image analysis software Image Pro Plus6.0,and the bone volume fraction(BV/TV)of the implant area was measured.After the bone tissue specimens were removed,the implant cavity was prepared step by step,and then the Straumann soft tissue horizontal implant was implanted.The assistant recorded the maximum insertion torque value(ITV)during implantation,and the Implant Stability Quotient(ISQ)of the implant was measured immediately by resonance frequency analysis(RFA).Results A total of 68 missing teeth were included in 57 patients with posterior tooth loss,including 32 cases in maxilla and 25 cases in mandible.1 There was a positive correlation between BV/TV and ITV and ISQ in posterior dental implant area(r = 0.823,r = 0.828,P < 0.05).The correlation coefficients between BV/TV and ITV and ISQ in maxillary posterior implant area were 0.856 and 0.862 respectively,while those between BV/TV and ITV and ISQ in mandibular posterior implant area were 0.815 and 0.835 respectively.2 The average values of BV/TV,ITV and ISQ in the posterior maxillary dental implant area were 21.29±1.73%,25.11±7.12 N.cm,and 48.00±7.33;the average values of BV/TV,ITV and ISQ in the posterior mandibular implant area were 49.14±5.40%,36.00±8.51 N.cm,58.88±9.40.In this study,there were significant differences in the parameters of the implant area between the maxillary and mandibular posterior teeth(P < 0.05),and the implant area of the mandibular posterior teeth was higher than that of the maxillary posterior teeth(P < 0.05).There was no significant difference in BV/TV,ITV and ISQ in posterior dental implant area between males and females.3 There was a correlation between ITV and ISQ in the implant area of maxillary and mandibular posterior teeth,and the correlation coefficients were 0.632 and 0.689,respectively.Conclusion The higher the bone volume fraction in the posterior dental implant area,the better the initial stability of the implant.The bone volume fraction and initial stability of the mandibular posterior dental implant area were higher than those of the maxillary posterior dental implant area.There is also a correlation between the two parameters to evaluate the initial stability of the implant.This study provides an objective index for evaluating the bone mineral density of the posterior teeth of the jaw and a theoretical support for predicting the success rate of postoperative implant. |
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