Alsaadi Ghada, Quirynen Marc, Komárek Arnost, van Steenberghe Daniel
Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
Clin Oral Implants Res. 2008 Jul;19(7):670-6. doi: 10.1111/j.1600-0501.2008.01534.x. Epub 2008 May 19.
This retrospective study was set to assess the influence of systemic and local bone and intra-oral factors on the occurrence of implant loss from abutment connection up to 2 years.
The files of 700 patients, have been collected randomly from the total patient group treated by means of endosseous Brånemark system implants (Nobel Biocare, Gothenburg, Sweden) at the Department of Periodontology of the University Hospital of the Catholic University of Leuven. The end point observation was evaluating the loss of the implants 2 years after abutment installation. The study involved all implants that did not encounter early loss and implants for which it was possible to evaluate its status 2 years after abutment surgery. Thus, data of 412 patients (240 females) provided with 1514 implants were analyzed. For each patient, the medical history was carefully checked. Data collection and analysis were mainly focused on endogenous factors such as hypertension, coagulation problems, osteoporosis, hypo- hyperthyroidism, chemotherapy, diabetes type I or II, Crohn's disease, some local factors [e.g. bone quality and quantity, implant (length, diameter, location), type of edentulism, PTV, radiotherapy], smoking habits, and breach of sterility during surgery.
Radiotherapy, implant (diameter and location), and higher PTV at implant insertion and abutment connection, all affected significantly the implant loss.
Implant location in the oral cavity and radiotherapy seem predominant to explain the occurrence of implant loss. On the other hand, smoking and systemic health factors do not seem to be prominent players in the etiology of late implant loss.
本回顾性研究旨在评估全身和局部骨骼及口腔内因素对种植体从基台连接至2年内丢失情况的影响。
从鲁汶天主教大学医院牙周病科采用骨内Brånemark系统种植体(诺贝尔生物公司,瑞典哥德堡)治疗的全部患者组中随机收集700例患者的档案。终点观察指标是评估基台安装2年后种植体的丢失情况。该研究纳入了所有未早期丢失且在基台手术后2年能够评估其状态的种植体。因此,对412例患者(240名女性)的1514枚种植体的数据进行了分析。对每位患者的病史进行了仔细检查。数据收集和分析主要集中在内源性因素,如高血压、凝血问题、骨质疏松症、甲状腺功能减退或亢进、化疗、I型或II型糖尿病、克罗恩病,一些局部因素[如骨质量和数量、种植体(长度、直径、位置)、无牙类型、牙周炎严重程度、放疗]、吸烟习惯以及手术期间的无菌操作违规情况。
放疗、种植体(直径和位置)以及种植体植入和基台连接时较高的牙周炎严重程度均对种植体丢失有显著影响。
口腔内种植体位置和放疗似乎是解释种植体丢失发生的主要因素。另一方面,吸烟和全身健康因素在晚期种植体丢失的病因中似乎不是主要因素。