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影响4例种植体支持的下颌全牙弓修复体周围种植体周骨吸收的因素:一项为期3年的前瞻性研究。

Factors affecting peri-implant bone resorption in four Implant supported mandibular full-arch restorations: a 3-year prospective study.

作者信息

Krennmair Stefan, Weinländer Michael, Forstner Thomas, Krennmair Gerald, Stimmelmayr Michael

机构信息

Ludwig-Maximillian-University (LMU), University Munich, Munich, Germany.

Medical University Graz, Austria.

出版信息

J Clin Periodontol. 2016 Jan;43(1):92-101. doi: 10.1111/jcpe.12469. Epub 2016 Jan 26.

Abstract

BACKGROUND

Peri-implant marginal bone-level (MBL) alteration represents one of the parameters included in the criteria for determining implant health.

OBJECTIVE

Factors affecting peri-implant MBL alteration for 4-implant-supported fixed mandibular prostheses (4-ISFMP) were assessed.

MATERIAL & METHODS: A 3-year prospective, cohort study was conducted on 44 mandibularly edentulous patients treated with 4-ISFMP. Peri-implant MBL alteration was evaluated radiographically at the 12-, 24- and 36-month follow-ups considering to patient-related risk factors [age, gender, diabetes mellitus, smoking, cardiovascular disease (CVD), rheumatic disorders (RD)] and implant/prosthesis-related features (implant location, keratinized gingiva, denture cantilever length, prosthesis supporting zone, opposing dentition) as well as to peri-implant biological parameters (plaque-, bleeding-, calculus index).

RESULTS

148/176 implants (37 patients, drop-out: 15%) were followed for 3 years showing significant (p < 0.001) annual differences of MBL alterations over time. The univariate analysis demonstrated differences of MBL alterations for smokers (p = 0.014), for patients with CVD (p = 0.001) and RD (p = 0.011). In the 3-year multivariate analysis, MBL alteration was influenced by time (p < 0.001) and showed relationship with risk factors as smoking (p < 0.002; OR = 18.965), CVD (p < 0.021; OR = 5.172), RD (p < 0.006; OR = 50.171) and plaque-index (p = 0.034; OR = 3.252).

CONCLUSIONS

Although peri-implant MBL alteration increased annually, significant odds ratios, were found for patients-related risk factors identifying them potentiating the alterations.

摘要

背景

种植体周围边缘骨水平(MBL)改变是确定种植体健康标准所包含的参数之一。

目的

评估影响4种植体支持的固定下颌修复体(4-ISFMP)种植体周围MBL改变的因素。

材料与方法

对44例接受4-ISFMP治疗的下颌无牙患者进行了为期3年的前瞻性队列研究。在12个月、24个月和36个月的随访中,通过影像学评估种植体周围MBL改变,并考虑患者相关危险因素[年龄、性别、糖尿病、吸烟、心血管疾病(CVD)、风湿性疾病(RD)]以及种植体/修复体相关特征(种植体位置、角化龈、义齿悬臂长度、修复体支持区、对颌牙列)以及种植体周围生物学参数(菌斑、出血、牙石指数)。

结果

148/176颗种植体(37例患者,失访率:15%)随访3年,显示MBL改变随时间有显著(p < 0.001)的年度差异。单因素分析显示吸烟者(p = 0.014)、CVD患者(p = 0.001)和RD患者(p = 0.011)的MBL改变存在差异。在3年的多因素分析中,MBL改变受时间影响(p < 0.001),并与吸烟(p < 0.002;OR = 18.965)、CVD(p < 0.021;OR = 5.172)、RD(p < 0.006;OR = 50.171)和菌斑指数(p = 0.034;OR = 3.252)等危险因素有关。

结论

虽然种植体周围MBL改变每年都在增加,但发现患者相关危险因素的显著优势比,表明这些因素会加剧改变。

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