植体小知识丨关于种植体-基台微间隙

基台和种植体间运用螺丝固位的种植系统已在临床上使用数十年，且其长期成功率也有许多文献支持。然而此类连接方式会出现一个问题，那就是基台螺丝松动和断裂。螺丝松动可能是修复体未能形成良好的生物学封闭效果，和/或咬合力设计过载。

种植体的失败一般分为四类：生物学失败、机械性失败、医源性失败和功能性失败。种植体失败大多数是因为种植体负荷过大或植体周围软组织被感染而造成的脱落。

有研究报道称螺丝固位的基台内部，微生物能通过种植体和基台连接处的间隙而进入。也有报道称基台螺丝较容易松动（文献）。

种植体和基台连接处的微间隙有生物学和机械性两方面问题。生物学上的问题与基台螺丝上部发现的微生物有关，而这一点通过在体实验发现会形成细菌堆积，从而影响远期健康及种植体周围软组织。微间隙机械方面的问题是基台的微动以及螺丝的松动。

种植体和基台间的莫氏锥度内连接，被认为机械上更稳定连接更牢固。

根据文献报道，莫氏锥度的锥形界面，能更好的避免细菌侵入到连接的内部结构。此外，还有文献证明莫氏锥度连接的种植体能减少修复后并发症的出现，在皮质骨吸收上表现也更好。

Antonio Scarano, DDS, MD等人通过三维X断层扫描及微间隙测量，对40颗种植体进行了体外检测研究。这40颗种植体被分为四组：

• 组1：螺丝连接基台-种植体
  
• 组2：莫氏锥度连接基台-种植体
  
• 组3：莫氏锥度连接基台-种植体
  
• 组4：螺纹三叶连接基台-种植体
  

通过运用X射线显微CT技术，对种植体-基台连接处的微间隙进行观察发现，基台的锥形部分与种植体的内表面有几毫米的紧密接触，几乎无法发现微间隙，因为这两个部分看起来非常吻合。

此外，两组莫氏锥度连接植体，在种植体-基台界面和植体内部的微间隙和空隙的体积相比其他两组也更小。该方法对评估和发现不同种植体-基台连接方式的生物学和机械性能差异非常有价值。

在这次研究中，莫氏锥度内连接方式，显示出***的吻合性，完全没有微间隙存在。

科尼考®Conical种植体，一款您值得了解的种植体！

Implant-Abutment Contact Surfaces and Microgap Measurements of Different Implant Connections Under 3-Dimensional X-Ray Microtomography，Antonio Scarano, DDS, MD, MS,* Luca Valbonetti, DVM,† Marco Degidi, MD, DDS,‡ Raffaella Pecci, ME, PhD,§ Adriano Piattelli, MD, DDS,¶ P. S. de Oliveira, DDS,k and Vittoria Perrotti, DDS, PhD#

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