Lee Jong-Bin, Kim Man-Yong, Kim Chang-Sung, Kim Young-Taek
Department of Periodontology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
Department of Prosthodontics, Ilsan Hospital, National Health Insurance Service, Goyang, Republic of Korea.
J Adv Prosthodont. 2016 Dec;8(6):494-503. doi: 10.4047/jap.2016.8.6.494. Epub 2016 Dec 15.
The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique.
The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis.
In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (<.001), PM (=.002), and PI (=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS.
The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.
本研究旨在比较在平均40个月的功能负荷期内，第一和第二磨牙区域采用双种植体夹板固定（2-IS）和单种植体修复（1-IR）的疗效，并为夹板固定技术提出适当的临床考量。
基于患者的完整医院记录，在1-IR组和2-IS组中检查以下临床因素：性别、平均年龄、种植体位置、功能负荷期、骨移植、临床冠-种植体比例、冠高间隙和水平距离。还评估了每位患者的机械并发症[即螺钉松动（SL）、螺钉折断、牙冠折断和反复SL]和生物并发症[即种植体周围黏膜炎（PM）和种植体周围炎（PI）]。在两组分析中，采用卡方检验和学生t检验来确定临床因素与并发症发生率之间的关系。使用受试者工作特征分析评估基于并发症的功能负荷期的最佳截断值。
总共调查了2005年至2014年期间植入408颗种植体的234例患者。1-IR组和2-IS组之间SL（<.001）、PM（=.002）和PI（=.046）的发生率存在显著差异。功能负荷期是2-IS中机械和生物并发症发生率的唯一有意义的临床因素。
2-IS的机械并发症发生率低于1-IR，而2-IS的生物并发症发生率更高。39.80个月和46.57个月的功能负荷期分别是预防生物和机械并发症的参考随访期。
