Choi Yong-Geun, Eckert Steven E, Kang Kyung Lhi, Shin Sang-Wan, Kim Young-Kyun
Int J Oral Maxillofac Implants. 2017 May/Jun;32(3):525-532. doi: 10.11607/jomi.5044.
To examine the disparity of single-crown implant failure with a similar loss of the splinted prosthesis in differing anatomical locations while controlling for other demographic and clinical variables that may confound the relationship between prosthesis types and implant loss.
A multicenter retrospective cohort study was designed to include patients treated with dental implants from 2003 to 2014. The variables included age, sex, systemic disease, bone graft, implant placement date, position of dental implant, length of dental implant, diameter of dental implant, loading time, type of prosthesis, type of opposing occlusion, latest check date, and survival or loss of the dental implant. The demographic and clinical variables' influence on the survival of dental implants was estimated by the Kaplan-Meier method. The position and diameter were adjusted for the accurate estimation of the relationship between the prosthesis type and survival of the dental implant with the Cox proportional hazard method.
A total of 1,151 dental implants from 403 patients were ascertained. After adjusting for the confounding effect of position and diameter, single-crown prostheses were 38.1 (95% CI: 15.1-118) times more likely to be lost than the connected-type prostheses. For single-crown implants, the waiting time for osseointegration before loading was the highest for the maxillary molar position and the lowest for the mandibular molar position (P < .0001), while the most frequent implant loss occurred in the maxillary anterior area, and the second frequent area was the maxillary molar position; the lowest occurrence of implant loss was for the mandibular molar position. This disparity was statistically significant (P = .0271).
Despite the high survival rates of endosseous implants as a whole, since the variation of implant loss was observed among the different anatomical positions for single-crown implants, special attention has to be given to the maxillary anterior and maxillary molar positions. A longer healing time assuming compensation for disadvantageous bone quality was not directly effective in increasing implant longevity in the vulnerable positions.
在控制可能混淆假体类型与种植体丢失之间关系的其他人口统计学和临床变量的同时，研究不同解剖位置上单冠种植体失败与夹板式修复体类似丢失情况的差异。
设计一项多中心回顾性队列研究，纳入2003年至2014年接受牙种植治疗的患者。变量包括年龄、性别、全身疾病、骨移植、种植体植入日期、牙种植体位置、牙种植体长度、牙种植体直径、加载时间、假体类型、对颌咬合类型、最新检查日期以及牙种植体的存活或丢失情况。采用Kaplan-Meier方法评估人口统计学和临床变量对牙种植体存活的影响。采用Cox比例风险法对位置和直径进行调整，以准确估计假体类型与牙种植体存活之间的关系。
共确定了来自403例患者的1151颗牙种植体。在调整位置和直径的混杂效应后，单冠假体丢失的可能性比连接式假体高38.1倍（95%可信区间：15.1 - 118）。对于单冠种植体，加载前骨整合的等待时间在上颌磨牙位置最高，在下颌磨牙位置最低（P < .0001），而种植体丢失最频繁发生在上颌前部区域，第二频繁的区域是上颌磨牙位置；种植体丢失发生率最低的是下颌磨牙位置。这种差异具有统计学意义（P = .0271）。
尽管总体上骨内种植体的存活率较高，但由于单冠种植体在不同解剖位置观察到种植体丢失的差异，因此必须特别关注上颌前部和上颌磨牙位置。假设对不利骨质量进行补偿的更长愈合时间并不能直接有效地增加脆弱位置种植体的使用寿命。
