Kramer F J, Schliephake H, Wichmann M
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover.
Mund Kiefer Gesichtschir. 1999 May;3 Suppl 1:S19-23. doi: 10.1007/PL00014509.
The aim of this retrospective study was to evaluate the long-term survival rate of dental implants in edentulous patients suffering from severe atrophy of the alveolar ridges in the upper jaw.
In total, 964 implants were inserted in 140 patients. A total of 481 implants were combined with an osteoplastic augmentation of the maxilla, and 483 implants were inserted directly in the atrophic bone. The success rate was determined using survival analysis, log rank tests and a Cox regression analysis.
The overall survival rate for all implants was 42.2% during an observation period of 11 years. Between implants combined with an osteoplasty and implants inserted in local bone tissue there were no significant differences in the survival rate. The survival rate of implants combined with an osteoplasty was significantly reduced in women and in the case of repeated insertion or augmentation. Interestingly, a few of the patients treated with an osteoplasty demonstrated high numbers of individual implant failures. Those patients were postmenopausal women exclusively. Among them there is probably a certain group with a very high risk of implant failures.
This study shows that oral rehabilitation with osteointegrated implants in patients with severely atrophic alveolar ridges in the upper jaw is still problematic.
本回顾性研究旨在评估上颌牙槽嵴严重萎缩的无牙患者牙种植体的长期存活率。
140例患者共植入964枚种植体。其中481枚种植体联合上颌骨成形术,483枚种植体直接植入萎缩骨。采用生存分析、对数秩检验和Cox回归分析确定成功率。
在11年的观察期内,所有种植体的总体存活率为42.2%。联合骨成形术的种植体与植入局部骨组织的种植体在存活率上无显著差异。联合骨成形术的种植体在女性患者以及重复植入或增量时存活率显著降低。有趣的是,一些接受骨成形术治疗的患者出现大量个体种植体失败。这些患者均为绝经后女性。其中可能存在一组种植体失败风险极高的患者。
本研究表明,上颌牙槽嵴严重萎缩患者采用骨整合种植体进行口腔修复仍存在问题。