de Araújo Nobre Miguel, Mano Azul António, Rocha Evangelista, Maló Paulo
Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Malo Clinic, Lisbon, Portugal.
Eur J Oral Sci. 2015 Jun;123(3):131-9. doi: 10.1111/eos.12185. Epub 2015 Apr 20.
This study aimed to identify risk factors for the incidence of peri-implant pathology. One-thousand, two-hundred and seventy-fifty patients (255 cases and 1020 controls), rehabilitated with dental implants, were included. Peri-implant pathology was defined as the presence of peri-implant pockets ≥ 5 mm, bleeding on probing, vertical bone loss, and loss of attachment ≥ 2 mm. Cases and controls were matched for age, gender, and duration of follow-up. A logistic regression model was used, with estimation of the OR for each variable and interaction, with a level of significance of 5%. The risk factors for peri-implant pathology were: history of periodontitis (OR = 19), bacterial plaque (OR = 3.6), bleeding (OR = 2.9), bone level on the medium third of the implant (OR = 13.9), lack of prosthetic fit or non-optimal screw joint (OR = 5.9), metal-ceramic restorations (OR = 3.9), and the interaction between bacterial plaque and the proximity of other teeth or implants (PROXI) (OR = 4.3). PROXI (OR = 0.44) exerted a protective effect when independent. Based on the results, peri-implant pathology represents a group of multifactorial situations with interaction of biological and biomechanical components in its pathogenesis. It was possible to model the condition and to assess, with high precision, the risk profile of each patient.
本研究旨在确定种植体周围病变发生的风险因素。纳入了1275例接受牙种植修复的患者(255例病例和1020例对照)。种植体周围病变定义为存在深度≥5mm的种植体周袋、探诊出血、垂直骨吸收以及附着丧失≥2mm。病例和对照在年龄、性别和随访时间上进行了匹配。使用逻辑回归模型,估计每个变量和交互作用的比值比(OR),显著性水平为5%。种植体周围病变的风险因素包括:牙周炎病史(OR = 19)、菌斑(OR = 3.6)、出血(OR = 2.9)、种植体中1/3的骨水平(OR = 13.9)、修复体贴合不良或螺钉连接不理想(OR = 5.9)、金属烤瓷修复体(OR = 3.9)以及菌斑与其他牙齿或种植体的邻近度(PROXI)之间的交互作用(OR = 4.3)。PROXI单独存在时具有保护作用(OR = 0.44)。基于这些结果,种植体周围病变代表了一组多因素情况,其发病机制涉及生物和生物力学成分的相互作用。可以对该疾病状态进行建模,并高精度地评估每位患者的风险概况。