对具有至少25年功能的粗糙表面钛种植体的回顾性队列研究。
Retrospective cohort study of rough-surface titanium implants with at least 25 years' function.
作者信息
Horikawa Tadashi, Odatsu Tetsurou, Itoh Takatoshi, Soejima Yoshiki, Morinaga Hutoshi, Abe Naruyoshi, Tsuchiya Naoyuki, Iijima Toshikazu, Sawase Takashi
机构信息
Kyushu Implant Research Group, 4-14 Kokaihonmachi, Chuo-ku, Kumamoto, 860-0851, Japan.
Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
出版信息
Int J Implant Dent. 2017 Sep 5;3(1):42. doi: 10.1186/s40729-017-0101-7.
BACKGROUND
The longitudinal clinical outcomes over decades contribute to know potential factors leading to implant failure or complications and help in the decision of treatment alternatives.
METHODS
The cases of all patients who received dental implants treated with titanium plasma-sprayed surfaces and whose prostheses were set in the period 1984-1990 at seven private practices were retrospectively analyzed. The cumulative survival rate, the cumulative incidence of peri-implantitis, and the complication-free prosthesis rate were calculated with Kaplan-Meier survival curves, and the factors' influence on implant survival rate and the incidence of peri-implantitis were determined by a single factor in univariate analyses and multivariate analyses.
RESULTS
A total of 223 implants and 106 prostheses were applied to 92 patients, and approx. 62% of the implants and patients dropped out over the 25 years following their treatment. The cumulative survival rates of the implants at 10, 15, and 25 years were 97.4, 95.4, and 89.8%, respectively. A significant difference was observed in the implant position. The cumulative incidences of peri-implantitis at 10, 15, and 25 years were 15.3, 21.0, and 27.9%, respectively. Significant differences were observed in the gender, implant type, and width of keratinized mucosa around the implant. The cumulative survival rates of mechanical complication-free prostheses at 10, 15, and 25 years were 74.9, 68.8, and 56.4%, respectively. The difference in the type of prosthesis resulted in significant differences.
CONCLUSIONS
The high rate of dropout during follow-up indicates the difficulty of determining long-term (> 25 years) prognoses. The gender, location, and width of keratinized mucosa affected the development of peri-implantitis, resulting in late failures. Implant-supported overdentures were frequently repaired. Tooth implant-supported prostheses are not recommended for long-term survival.
背景
数十年的纵向临床结果有助于了解导致种植体失败或并发症的潜在因素，并有助于治疗方案的决策。
方法
回顾性分析1984年至1990年期间在七家私人诊所接受钛等离子喷涂表面治疗且已安装假体的所有种植牙患者的病例。采用Kaplan-Meier生存曲线计算种植体的累积生存率、种植体周围炎的累积发病率和无并发症假体率，并通过单因素和多因素分析确定各因素对种植体生存率和种植体周围炎发病率的影响。
结果
共对92例患者应用了223颗种植体和106个假体，在治疗后的25年中，约62%的种植体和患者失访。种植体在10年、15年和25年的累积生存率分别为97.4%、95.4%和89.8%。种植体位置存在显著差异。种植体周围炎在10年、15年和25年的累积发病率分别为15.3%、21.0%和27.9%。在性别、种植体类型和种植体周围角化黏膜宽度方面存在显著差异。无机械并发症假体在10年、15年和25年的累积生存率分别为74.9%、68.8%和56.4%。假体类型的差异导致了显著差异。
结论
随访期间的高失访率表明确定长期（>25年）预后存在困难。性别、角化黏膜的位置和宽度影响种植体周围炎的发生，导致后期失败。种植体支持的覆盖义齿经常需要修复。不建议使用牙种植体支持的假体进行长期生存。
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