Department of Dental Specialties, Mayo Clinic, Rochester, MN.
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
J Prosthodont. 2019 Aug;28(7):743-749. doi: 10.1111/jopr.12773. Epub 2018 Mar 5.
The probability of achieving important clinical outcomes is an increasingly important factor for patients considering various treatment options for tooth loss. For oral reconstruction involving dental implants, the patient-specific risks of implant failure may be influenced by the patient's medication profile. The purpose of this study was to identify associations between dental implant failure and medication use in a consecutive series of patients seen from October 1983 through December 2014 at the Department of Dental Specialties, Mayo Clinic (Rochester, Minnesota).
In this patient-level analysis, demographic, implant-specific, and medical profile data were abstracted from a prospective clinical database and individual medical records and used to determine the time to first implant failure. Implant failure-free survival at the patient level was estimated using the Kaplan-Meier method. Associations of demographic characteristics and medication use with implant failure were evaluated by using Cox proportional hazards regression models and summarized with hazard ratios and 95% confidence intervals.
In the 31-year study period, 6358 patients received their first dental implant (median age, 53 years). The median follow-up duration of the 5645 patients whose implants did not fail was 5.8 years, and 713 patients had implant failure (median, 0.6 years). All associations were adjusted for age, sex, and era of implantation because these features strongly influence medication use and implant failure. After adjustment, no medication increased the risk of implant failure in the cohort; specifically, medication use at the time of implant placement or starting a medication after implant placement did not increase the risk of implant failure. Among the medications used at the time of implant placement, corticosteroids were associated with a reduced risk of implant failure (hazard ratio, 0.82; 95% CI, 0.67-0.99; p = 0.04). This association was not seen when corticosteroids were started after implant placement.
In the population studied, medication use was not associated with an increased risk of dental implant failure.
对于考虑各种缺牙治疗方案的患者而言,获得重要临床结局的概率是一个日益重要的因素。对于涉及牙种植体的口腔重建,患者特有的种植体失败风险可能受患者用药情况的影响。本研究旨在通过明尼苏达州罗切斯特市梅奥诊所牙科专业部 1983 年 10 月至 2014 年 12 月连续就诊患者的系列研究,明确种植体失败与药物使用之间的相关性。
在这项患者水平分析中,我们从前瞻性临床数据库和个人病历中提取了人口统计学、种植体特异性和医疗档案数据,以确定首次种植体失败的时间。使用 Kaplan-Meier 方法估计患者水平的种植体无失败生存率。采用 Cox 比例风险回归模型评估人口统计学特征和药物使用与种植体失败的相关性,并以风险比和 95%置信区间进行总结。
在 31 年的研究期间,有 6358 例患者接受了首次牙种植(中位年龄 53 岁)。5645 例种植体未失败患者的中位随访时间为 5.8 年,有 713 例患者发生种植体失败(中位时间 0.6 年)。由于这些特征强烈影响药物使用和种植体失败,所有相关性均经过年龄、性别和种植体植入时代的调整。调整后,该队列中没有任何药物会增加种植体失败的风险;具体来说,种植体放置时或放置后开始使用药物并不会增加种植体失败的风险。在种植体放置时使用的药物中,皮质类固醇与降低种植体失败风险相关(风险比,0.82;95%CI,0.67-0.99;p = 0.04)。而在种植体放置后开始使用皮质类固醇时,并未观察到这种相关性。
在本研究人群中,药物使用与牙种植体失败的风险增加无关。