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芬兰引入锥形束 CT 后,种植牙失败的医疗事故索赔是否减少了?

Did malpractice claims for failed dental implants decrease after introduction of CBCT in Finland?

机构信息

Department of Radiology, University of Helsinki, Helsinki, Finland.

HUS Radiology (Medical Imaging Center), Helsinki, Finland.

出版信息

Clin Oral Investig. 2019 Jan;23(1):399-404. doi: 10.1007/s00784-018-2448-4. Epub 2018 Apr 20.

DOI:10.1007/s00784-018-2448-4
PMID:29679231
Abstract

OBJECTIVES

To examine the role of cone beam computed tomography (CBCT) in preventing failures in implant treatment. We hypothesize that the number of malpractice claims related to dental implant treatment would decrease after the first CBCT device came available in 2002 in Finland.

MATERIAL AND METHODS

Data concerning malpractice claims related to dental implant treatment during the years 1997-2011 were collected from the Finnish Patient Insurance Centre (N = 330 subjects). We selected the cases that might have benefitted from the use of CBCT examination. These cases (n = 131) led to financial compensation due to permanent inferior alveolar nerve injury, improper implant position, or insufficient amount of bone for the implant. The annual total number of inserted dental implants, CBCT devices, and CBCT examinations in Finland were drawn from the national registers and used to estimate the impact of CBCT in preventing treatment failures.

RESULTS

The most common reason for all failures (n = 268 implants) was an improper implant position (46.3%). The most common area of malpractices was upper front teeth (34%). We have noticed a fall in the rate of compensable malpractice cases concerning implant failure, simultaneously with CBCT technology emerging on the market.

CONCLUSIONS

There may be an association between the increasing availability of CBCT equipment and the reducing frequency of compensable malpractice claims.

CLINICAL RELEVANCE

It is possible that the use of CBCT may result in fewer compensable malpractice claims.

摘要

目的

探讨锥形束 CT(CBCT)在预防种植体治疗失败中的作用。我们假设,2002 年芬兰首次推出 CBCT 设备后,与牙种植体治疗相关的医疗事故索赔数量将会减少。

材料与方法

从芬兰患者保险中心(N=330 名患者)收集了 1997 年至 2011 年期间与牙种植体治疗相关的医疗事故索赔数据。我们选择了可能受益于 CBCT 检查的病例。这些病例(n=131)因永久性下牙槽神经损伤、植入物位置不当或植入物所需骨量不足而导致财务赔偿。芬兰全国注册中心的数据显示,每年植入的牙种植体总数、CBCT 设备数量和 CBCT 检查数量,用于评估 CBCT 在预防治疗失败方面的作用。

结果

所有失败病例(n=268 个植入物)的最常见原因是植入物位置不当(46.3%)。最常见的医疗事故发生部位是上前牙(34%)。我们注意到,随着 CBCT 技术在市场上的出现,可赔偿的种植体失败医疗事故案件的发生率有所下降。

结论

CBCT 设备的可用性增加与可赔偿医疗事故索赔的频率降低之间可能存在关联。

临床意义

使用 CBCT 可能会减少可赔偿的医疗事故索赔。

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