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牙种植体折断原因分析:一项回顾性临床研究。

Analysis of the causes of dental implant fracture: A retrospective clinical study.

作者信息

Stoichkov Biser, Kirov Dimitar

出版信息

Quintessence Int. 2018;49(4):279-286. doi: 10.3290/j.qi.a39846.

DOI:10.3290/j.qi.a39846
PMID:29435519
Abstract

OBJECTIVE

Fracture of osseointegrated dental implants is the most severe mechanical complication. The aim of the present study was to analyze possible causative factors for implant body fracture.

METHOD AND MATERIALS

One hundred and one patients with 218 fitted implants and a follow-up period of 3 to 10 years were studied. Factors associated with biomechanical and physiologic overloading such as parafunctional activity (eg, bruxism), occlusion, and cantilevers, and factors related to the planning of the dental prosthesis, available bone volume, implant area, implant diameter, number of implants, and their inclination were tracked. The impact of their effect was analyzed using the Bonferroni-corrected post-hoc Mann-Whitney test for each group.

RESULTS

The incidence of dental implant fracture was 2.3% in the investigated cases. Improper treatment planning, bruxism, and time of the complication setting in were the main factors leading to this complication. Typical size effect was established only for available bruxism, occlusal errors, and their activity duration. These complications were observed most often with single crown prostheses, and in combination with parafunctional activities such as bruxism and lack of implant-protected occlusion.

CONCLUSION

Occlusal overload due to bruxism or inappropriate or inadequate occlusion as a single factor or a combination of these factors during the first years after the functional load can cause implant fracture. Fracture of the implant body more frequently occurred with single crowns than with other implant-supported fixed dental prostheses.

摘要

目的

骨结合式牙种植体骨折是最严重的机械并发症。本研究的目的是分析种植体体部骨折可能的致病因素。

方法和材料

对101例患者的218颗已植入种植体进行了研究,随访期为3至10年。追踪与生物力学和生理过载相关的因素,如副功能活动(如磨牙症)、咬合和悬臂,以及与牙修复体设计、可用骨量、种植区域、种植体直径、种植体数量及其倾斜度相关的因素。使用Bonferroni校正的事后曼-惠特尼检验分析每组中这些因素的影响。

结果

在所调查的病例中,牙种植体骨折的发生率为2.3%。治疗计划不当、磨牙症以及并发症发生的时间是导致该并发症的主要因素。仅在存在磨牙症、咬合错误及其活动持续时间的情况下确定了典型的尺寸效应。这些并发症最常出现在单冠修复体中,并且与磨牙症等副功能活动以及缺乏种植体保护的咬合有关。

结论

在功能负荷后的头几年,由于磨牙症或不当或不足的咬合导致的咬合过载作为单一因素或这些因素的组合可导致种植体骨折。种植体体部骨折在单冠修复体中比在其他种植体支持的固定牙修复体中更频繁发生。

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