Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA.
Int J Oral Maxillofac Implants. 2012 Jan-Feb;27(1):102-10.
The purpose of this systematic review was to assess the incidence and types of biologic and technical complications associated with implant-supported fixed complete dental prostheses (IFCDPs) for edentulous patients.
An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and prospective cohort studies with IFCDPs for edentulous patients. Reports with at least 5 years of follow-up after prosthesis insertion were selected. Pooled data were analyzed statistically, and the cumulative complication rates were calculated by meta-analysis and regression.
Of a total of 281 one-piece IFCDPs (mean exposure time of 9.5 years) and 653 complication events, the complication rate was estimated at 24.6% per 100 restoration-years. The cumulative rates of "prosthesis free of complications" after 5 and 10 years were 29.3% and 8.6%, respectively. The most common implantrelated biologic complication was peri-implant bone loss (> 2 mm), at rates of 20.1% after 5 years and 40.3% after 10 years. The most frequent implant-related technical complication was screw fracture, yielding a 5-year complication rate of 10.4% and a 10-year rate of 20.8%. The most frequent prosthesis-related biologic complication was hypertrophy or hyperplasia of tissue around the IFCDPs (13.0% and 26.0% after 5 and 10 years, respectively). The most common prosthesis-related technical complication reported with IFCDPs was chipping or fracture of the veneering material (33.3% at 5 years and 66.6% at 10 years).
Biologic and technical complications after the placement of IFCDPs occur continuously over time as a result of fatigue and stress. These events may not lead to implant/prosthetic failures, but they are significant in relation to the amount of repair and maintenance needed, time, and cost to both the clinician and patient.
本系统评价的目的是评估无牙患者种植体支持的固定全口义齿（IFCDP）相关的生物学和技术并发症的发生率和类型。
通过电子 MEDLINE/PubMED 搜索，确定了针对无牙患者的 IFCDP 的随机对照临床试验和前瞻性队列研究。选择了至少在义齿插入后 5 年进行随访的报告。通过荟萃分析和回归对汇总数据进行了统计学分析，并计算了累积并发症发生率。
在总共 281 个单件 IFCDP（平均暴露时间为 9.5 年）和 653 个并发症事件中，每 100 个修复年的并发症发生率估计为 24.6%。5 年和 10 年后“无并发症的义齿”的累积率分别为 29.3%和 8.6%。最常见的与植入物相关的生物学并发症是种植体周围骨丢失（>2mm），5 年后的发生率为 20.1%，10 年后的发生率为 40.3%。最常见的与植入物相关的技术并发症是螺钉断裂，5 年后的并发症发生率为 10.4%，10 年后的发生率为 20.8%。最常见的与义齿相关的生物学并发症是 IFCDP 周围组织的肥大或增生（5 年后分别为 13.0%和 26.0%，10 年后）。与 IFCDP 相关的最常见的技术并发症是贴面材料的碎裂或断裂（5 年后为 33.3%，10 年后为 66.6%）。
由于疲劳和压力，IFCDP 放置后生物学和技术并发症会随着时间的推移而持续发生。这些事件可能不会导致种植体/义齿失败，但与所需的修复和维护量、时间以及临床医生和患者的成本有关，具有重要意义。
