Carr Alan B, Revuru Venkata S, Lohse Christine M
Int J Oral Maxillofac Implants. 2017 Sep/Oct;32(5):1153-1161. doi: 10.11607/jomi.5888.
Outcome research has become an increasingly important form of clinical evidence for making health care decisions, including oral health considerations in the field of dentistry. In oral reconstruction involving dental implants, the risk of implant failure may be influenced by a patient’s underlying medical condition. To identify associations, implant failure and systemic conditions or diseases were studied in a consecutive series of patients who received dental implants from October 1, 1983, to December 31, 2014, in the Department of Dental Specialties at Mayo Clinic in Rochester, Minnesota.
Data were abstracted from a prospective clinical database and electronic health records for patients’ demographic, implant-specific, and medical profiles to determine time to first implant failure. Survival free of implant failure at the patient level was estimated by using the Kaplan-Meier method. Associations of demographic and systemic characteristics with implant failure were evaluated by using Cox proportional hazards regression models and summarized with hazard ratios and 95% confidence intervals.
The patient cohort consisted of 6,358 patients with a median age of 53 years at placement of the first implant. A total of 713 patients experienced implant failure at a median of 0.6 years. Among the 5,645 patients who did not experience implant failure, the median duration of follow-up was 5.8 years. More than 20 systemic diseases or conditions were identified for assessment, of which 15 comprised more than 50 patients and five comprised more than 500 patients. All associations were adjusted for age, sex, and era of implant, given the strong influence of these features on implant failure. After adjustment, no systemic disease or condition was shown to increase the risk for implant failure in the population and setting studied.
Patients considering oral reconstruction involving implants in the medical setting studied do not appear to risk implant loss because of systemic conditions or diseases.
结果研究已成为医疗保健决策中越来越重要的临床证据形式，包括牙科领域的口腔健康考量。在涉及牙种植体的口腔修复中，种植体失败的风险可能受患者潜在健康状况的影响。为了确定相关性，我们对1983年10月1日至2014年12月31日在明尼苏达州罗切斯特市梅奥诊所牙科专科接受牙种植体的一系列连续患者进行了研究，分析种植体失败与全身状况或疾病之间的关系。
从前瞻性临床数据库和电子健康记录中提取患者的人口统计学、种植体特异性和医疗资料数据，以确定首次种植体失败的时间。采用Kaplan-Meier方法估计患者层面无种植体失败的生存率。使用Cox比例风险回归模型评估人口统计学和全身特征与种植体失败的相关性，并用风险比和95%置信区间进行总结。
患者队列包括6358名患者，首次种植时的中位年龄为53岁。共有713名患者在中位时间0.6年时出现种植体失败。在5645名未出现种植体失败的患者中，中位随访时间为5.8年。确定了20多种全身疾病或状况进行评估，其中15种疾病的患者超过50人，5种疾病的患者超过500人。考虑到这些特征对种植体失败有很大影响，所有相关性均针对年龄、性别和种植时代进行了调整。调整后，在所研究的人群和环境中，没有全身疾病或状况显示会增加种植体失败的风险。
在本研究的医疗环境中，考虑进行涉及种植体的口腔修复的患者似乎不会因全身状况或疾病而面临种植体丢失的风险。
