He Jing, Zhao Baohong, Deng Chunfu, Shang Dehao, Zhang Chong
Int J Oral Maxillofac Implants. 2015 Mar-Apr;30(2):360-71. doi: 10.11607/jomi.3580.
This retrospective study was set to explore the influence of local bone density (BD) on implant cumulative survival rates (ICSRs) and to assess prognostic factors associated with implant failure at sites with different BD.
Between January 2005 and December 2011, 2,684 implants were placed in 1,377 patients and included in the study. Implants at sites with different BD were divided into four groups (G1 to G4) according to the Lekholm and Zarb classification, corresponding to bone types 1 to 4. ICSRs and the reasons for failure in each group were evaluated. Factors related to the local distribution of BD were also analyzed. A number of predictive variables were examined by univariate and multivariate analyses to evaluate prognostic factors and their influence on implant failure rates.
In total, 45 implants were lost, resulting in ICSRs for G1 to G4 of 100%, 98.18%, 96.83%, and 92.25%, respectively. The main reasons for failure in each group were failed osseointegration and occlusal overloading. Low BD was associated with advanced age (> 50 years) and the posterior maxilla. Based on multivariate analysis, diabetes mellitus and nonthreaded implants were significant factors in the high-BD group (G2), while advanced age, smoking, nonthreaded implants, and immediate loading were risk factors for the low-BD group (G3 and G4).
BD is one of the most important factors influencing the long-term ICSR, which decreases with decreasing BD values. Accurate risk evaluation for sites with different BD before implantation will be beneficial to implant survival.
本回顾性研究旨在探讨局部骨密度（BD）对种植体累积生存率（ICSRs）的影响，并评估不同骨密度部位种植体失败的相关预后因素。
2005年1月至2011年12月期间，1377例患者共植入2684枚种植体并纳入本研究。根据Lekholm和Zarb分类，将不同骨密度部位的种植体分为四组（G1至G4），分别对应骨类型1至4。评估每组的种植体累积生存率及失败原因。同时分析与局部骨密度分布相关的因素。通过单因素和多因素分析检查了多个预测变量，以评估预后因素及其对种植体失败率的影响。
总共45枚种植体丢失，G1至G4组的种植体累积生存率分别为100%、98.18%、96.83%和92.25%。每组失败的主要原因是骨结合失败和咬合过载。低骨密度与高龄（>50岁）和上颌后部有关。多因素分析显示，糖尿病和非螺纹种植体是高骨密度组（G2）的显著因素，而高龄、吸烟、非螺纹种植体和即刻负重是低骨密度组（G3和G4）的危险因素。
骨密度是影响种植体长期累积生存率的最重要因素之一，种植体累积生存率随骨密度值降低而下降。植入前对不同骨密度部位进行准确的风险评估将有利于种植体的存活。
