Gianserra Rodolfo, Cavalcanti Raffaele, Oreglia Francesco, Manfredonia Massimo Francesco, Esposito Marco
Department of Biomaterials, The Sahlgrenska Academy at Göteborg University, Sweden.
Eur J Oral Implantol. 2010 Winter;3(4):307-14.
To evaluate the outcome of dental implants placed in patients with a history of periodontitis. Patients with no or mild history of periodontitis served as controls.
A total of 1727 patients were consecutively treated in four private practices. Patients were divided into three groups according to their initial periodontal conditions assessed with a modified periodontal screening and recording (PSR) index: 630 patients were in the severe periodontitis (SP) group, 839 in the moderate periodontitis (MP) group, and 258 had no periodontitis (NP). Patients requiring periodontal treatment were treated prior to implantation. Various implant systems and procedures were used. In total, 3260 implants and 1707 implant-supported prostheses were placed in the SP group, 2813 implants and 1744 implant-supported prostheses in the MP group, and 647 implants and 424 implant-supported prostheses in the NP group. Mixed implant–tooth supported prostheses (98 prostheses in 89 patients) were not considered. Outcome measures were prosthesis and implant survival.
Two-hundred and fifty patients were lost to follow-up 5 years after loading. Regarding prosthesis failures, 13 prostheses could not be placed or failed in 13 patients of the SP group (0.8%), 11 prostheses could not be placed or failed in 9 patients of the MP group (0.7%), and 3 prostheses failed in 3 patients of the NP group (0.9%). For implant failures, 130 (4.5%) implants failed in the SP group, 74 (3.1%) implants failed in the MP group, and 15 (3.0%) implants failed in the NP group. Most of the implant failures (90%) occurred before implant loading. Fitting a logistic regression for early implant failures and total implant failures, taking into account the clustering of implants in patients, there were no statistically significant differences between the three PSR groups (P > 0.05).
Owing to the retrospective nature of this study, conclusions need to be interpreted with caution. A previous history of periodontal disease may not have a significant impact on implant failures up to 5 years after loading.
评估有牙周炎病史患者种植牙的治疗效果。无牙周炎病史或仅有轻微牙周炎病史的患者作为对照组。
共有1727例患者在四家私人诊所接受连续治疗。根据改良牙周筛查与记录(PSR)指数评估的初始牙周状况,将患者分为三组:重度牙周炎(SP)组630例患者,中度牙周炎(MP)组839例患者,无牙周炎(NP)组258例患者。需要牙周治疗的患者在种植前接受治疗。使用了各种种植系统和手术方法。SP组共植入3260颗种植体和1707个种植体支持的修复体,MP组植入2813颗种植体和1744个种植体支持的修复体,NP组植入647颗种植体和424个种植体支持的修复体。不考虑混合种植体 - 牙齿支持的修复体(89例患者中的98个修复体)。观察指标为修复体和种植体的存留率。
负重5年后,250例患者失访。关于修复体失败情况,SP组有13例患者的13个修复体无法放置或失败(0.8%),MP组有9例患者的11个修复体无法放置或失败(0.7%),NP组有3例患者的3个修复体失败(0.9%)。对于种植体失败情况,SP组有130颗种植体失败(4.5%),MP组有74颗种植体失败(百分之3.1),NP组有15颗种植体失败(3.0%)。大多数种植体失败(90%)发生在种植体负重前。在考虑患者种植体聚集情况的前提下,对早期种植体失败和种植体总失败情况进行逻辑回归分析,三个PSR组之间无统计学显著差异(P>0.05)。
由于本研究的回顾性特点,结论需谨慎解读。牙周疾病既往史在负重后长达5年的时间内可能对种植体失败无显著影响。