Herrmann I, Lekholm U, Holm S, Karlsson S
Brånemarkkliniken, Public Dental Health and Faculty of Odontology, Göteborg University, Sweden.
Int J Prosthodont. 1999 Mar-Apr;12(2):160-6.
When evaluating the outcome of oral implant treatment, a statistically important aspect to consider is whether any dependency exists among implants placed within the same patient/jaw. If one implant fails, will the risk of subsequent failures increase, i.e., will any of the remaining implants also fail? In an attempt to study this question, the aims of the present study were to statistically determine if the suggested hypothesis was valid, i.e., whether dependency exists among implants in the same patient/jaw, and to determine how failure lifetable analysis should be calculated.
In the present study, multicenter trial material consisting of 1.738 oral implants in 487 patients from 4 separate studies was used. First, any dependency among implants within the same patient/jaw was determined; thereafter, cumulative success rates were calculated for one implant per patient (chosen randomly), and the range of variations in the randomized success rates was also calculated. This was then compared with the cumulative success rates based on the entire material.
The statistical analysis showed that a dependency among the implants existed prior to their functional loading, i.e., the risk for an implant failure among the remaining implants in the same patient/jaw increased after the first failure had occurred.
Both study design and statistical analysis are of importance when comparing success rates from various investigations, since dependency among implants in the same patient/jaw does exist and may influence the success rates. Consequently, it is suggested that only one randomly selected implant from each patient should be considered when calculating implant success rates.
在评估口腔种植治疗的结果时,一个需要从统计学角度考虑的重要方面是,在同一患者/颌骨内植入的种植体之间是否存在相关性。如果一个种植体失败,后续失败的风险会增加吗?也就是说,其余的种植体是否也会失败?为了研究这个问题,本研究的目的是从统计学角度确定所提出的假设是否成立,即在同一患者/颌骨内的种植体之间是否存在相关性,并确定应如何计算失败寿命表分析。
在本研究中,使用了来自4项独立研究的487例患者的1738颗口腔种植体的多中心试验材料。首先,确定同一患者/颌骨内种植体之间的任何相关性;此后,计算每位患者一颗随机选择的种植体的累积成功率,并计算随机成功率的变化范围。然后将其与基于整个材料的累积成功率进行比较。
统计分析表明,在种植体功能加载之前就存在相关性,即在同一患者/颌骨内,第一个种植体失败后,其余种植体失败的风险增加。
在比较不同研究的成功率时,研究设计和统计分析都很重要,因为同一患者/颌骨内的种植体之间确实存在相关性,并且可能影响成功率。因此,建议在计算种植体成功率时,每位患者仅应考虑一颗随机选择的种植体。