Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Brånemark Clinic, Public Dental Health Service, Region of Västra, Götaland, Sweden.
Clin Implant Dent Relat Res. 2017 Jun;19(3):413-422. doi: 10.1111/cid.12481. Epub 2017 Mar 1.
Few large-scale follow-up studies are reported on routine implant treatment.
To report retrospective data on peri-implantitis and overall implant failures at one private referral clinic (effectiveness study).
A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface during 1592 operations between 2000 and 2011. All patients with any of four events of problems were identified; "peri-implantitis," "surgery related to peri-implantitis," "overall implant failure," and "late implant failures." A logistic multivariate analysis was performed to identify possible factors with association to the four events.
"Lower jaw surgery" (HR = 3.03) and "immediate gingival grafting" at implant surgery (HR = 3.34) were factors with the highest risk associated to the two peri-implantitis events, respectively. Risk of peri-implantitis increased by year of inclusion from year 2000 (HR = 1.28). "Overall implant failures" were associated to "smoking" (HR = 2.11), "surgical technique" (highest for direct placement; HR = 1.67), and "type of implant" (NobelActive CC; HR = 2.48). NobelActive CC was more used in upper jaws, using immediate or one-stage surgery with bone and mucosa grafting procedures than other implants (P < .05). Implants lost after first year only showed an association to "lower jaw" (HR = 2.63) and "early inflammation" (HR = 17.95).
Peri-implantitis seem to be associated to surgical protocols more often in the posterior lower jaw in routine practice. The problems seem to increase during the inclusion period, possibly related to increased use of direct implant placement technique and grafting protocols. Early inflammatory problems have in the previous report on the present patient group been associated to the mid-aged patient. Overall/late implant failures were shown to be associated to earlier inflammatory problems, smoking habits, surgical technique, and treatment in the posterior lower jaw.
很少有大型的随访研究报道常规种植体治疗。
报告一家私人转诊诊所的种植体周围炎和种植体总体失败的回顾性数据(有效性研究)。
2000 年至 2011 年间,共 1017 名患者在 1592 次手术中接受了表面阳极氧化处理的 3082 枚种植体。所有发生以下四种情况之一的患者都被识别出来:“种植体周围炎”、“与种植体周围炎相关的手术”、“种植体总体失败”和“晚期种植体失败”。采用逻辑多元分析确定与这四个事件相关的可能因素。
“下颌手术”(HR=3.03)和“种植体手术时即刻牙龈移植”(HR=3.34)分别是与两种种植体周围炎事件关联度最高的危险因素。纳入年份为 2000 年时,种植体周围炎的风险增加(HR=1.28)。“种植体总体失败”与“吸烟”(HR=2.11)、“手术技术”(直接放置最高;HR=1.67)和“种植体类型”(NobelActive CC;HR=2.48)有关。NobelActive CC 在上颌中使用较多,与其他种植体相比,其更多地应用于即刻或一期手术,并采用骨和黏膜移植术(P<0.05)。仅在第一年丢失的种植体与“下颌”(HR=2.63)和“早期炎症”(HR=17.95)有关。
在常规治疗中,种植体周围炎似乎更多地与下颌后牙的手术方案有关。在纳入期间,问题似乎有所增加,这可能与直接种植体放置技术和移植方案的使用增加有关。早期炎症问题在上一组患者的报告中与中年患者有关。种植体总体/晚期失败与早期炎症问题、吸烟习惯、手术技术以及下颌后牙的治疗有关。