Evian Cyril I, Emling Robert, Rosenberg Edwin S, Waasdorp Jonathan A, Halpern Wendy, Shah Shalin, Garcia Marela
University of Pennsylvania School of Dentistry, Philadelphia, Pennsylvania, USA.
Int J Oral Maxillofac Implants. 2004 May-Jun;19(3):393-8.
The purpose of this study was to investigate the cumulative survival rates of dental implants placed in a private periodontal practice and the effects of periodontal disease and immediate placement on implant survival.
A retrospective chart review was conducted on 149 consecutive patients. Each patient had a single implant placed. For the purpose of analysis, patients were divided into 2 groups: those who were periodontally healthy and those who had periodontal disease. Implants were placed into available bone either immediately or after a healing period. All failed implants were removed and recorded. The effects of periodontal status and placement time on implant survival were evaluated using Cox proportional hazards regression and log-rank tests.
Of the 149 implants in the study, 22 failed during the observation period. The 127 censored cases (i.e., implants that had not failed at the end of the observational period) were observed for a mean of 943 days (SD 932, range 35 to 4,030). Failed implants were observed for a mean of 722 days (SD 1,026, range 18 to 3,548). The presence of periodontal disease appeared to be associated with a greater failure rate, but there was no observed effect associated with time of placement. The percentages of censored immediate placement cases and delayed placement cases were nearly identical. Among the 77 implants associated with periodontal disease, placement time was not strongly associated with percentage censored. Forty-three of the 55 immediately placed implants (78.18%) and 18 of the 22 implants (81.18%) whose placement was delayed were censored. Both Cox proportional hazards regression and log-rank tests established that survival was adversely affected by periodontal disease (P < .05) but unaffected by time of placement (P > .50). The lower 1-sided 95% confidence limit for median survival time was 3,548 days for patients without periodontal disease and 1,799 days for patients with disease.
Implant survival was compromised by a history of periodontitis but not affected by immediate or delayed placement.
本研究旨在调查在一家私人牙周诊所植入的牙种植体的累积生存率，以及牙周疾病和即刻种植对种植体存活的影响。
对149例连续患者进行回顾性病历审查。每位患者植入一枚种植体。为便于分析，将患者分为两组：牙周健康者和患有牙周疾病者。种植体在有可用骨的情况下即刻植入或在愈合期后植入。所有失败的种植体均被取出并记录。使用Cox比例风险回归和对数秩检验评估牙周状况和植入时间对种植体存活的影响。
在本研究的149枚种植体中，22枚在观察期内失败。127例截尾病例（即观察期结束时未失败的种植体）的平均观察时间为943天（标准差932，范围35至4030天）。失败种植体的平均观察时间为722天（标准差1026，范围18至3548天）。牙周疾病的存在似乎与更高的失败率相关，但未观察到与植入时间相关的影响。即刻植入截尾病例和延迟植入病例的百分比几乎相同。在与牙周疾病相关的77枚种植体中，植入时间与截尾百分比的相关性不强。55枚即刻植入的种植体中有43枚（78.18%）和22枚延迟植入的种植体中有18枚（81.18%）被截尾。Cox比例风险回归和对数秩检验均表明，牙周疾病对存活率有不利影响（P <.05），但不受植入时间影响（P >.50）。无牙周疾病患者中位生存时间的单侧95%置信下限为3548天，患有牙周疾病患者为1799天。
种植体的存活受到牙周炎病史的影响，但不受即刻或延迟植入的影响。
