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[种植体支持的全牙弓即刻修复体的并发症:114例回顾性分析]

[Complications of implant-supported full-arch immediate prosthesis: a retrospective analysis of 114 cases].

作者信息

Shen H D, Di P, Li J H, Luo J, Zhang Y, Lin Y

机构信息

Department of Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2018 Apr 9;53(4):236-242. doi: 10.3760/cma.j.issn.1002-0098.2018.04.005.

Abstract

To evaluate the feasibility of long-term function of implant-supported full-arch immediate prosthesis via assessing the complications and risk factors. This historical cohort study included patients treated with implant-supported full-arch restoration under immediate loading protocol between April, 2008 to June, 2016 and wearing the immediate prosthesis for more than 6 months. Medical charts were reviewed for patients' general information, implant information, prosthetic information and details of prosthetic complications. COX proportional hazards ratio model was adopted to analyze the potential risk factors for prosthesis fracture. A total of 114 patients with a mean age of (56.7±10.2) years old and 144 prostheses were included. The median wearing time of immediate prosthesis was 17.6 months. Sixty-two (54%) patients experienced prosthetic complication, 30 of them suffered more than once. Artificial teeth fractures were more common in anterior region while resin base fractured more often in the posterior region. The possibility of immediate prosthesis fracture in the first year was high but declined over the following years. COX regression analysis showed that fibre-reinforcement (=0.486, 0.017) and rigid opposing dentition (=2.272, 0.016) were significantly related to the prosthesis fracture. Long-term function of implant-supported full-arch immediate prosthesis renders a high prosthetic complication prevalence, featuring the prosthesis fracture as the most common complication and the first year of highest fracture probability. Fibre-reinforced acrylic immediate prosthesis may function well in cases with a removable denture restored opposing jaw.

摘要

通过评估并发症和风险因素来评估种植体支持的全牙弓即刻修复体的长期功能可行性。这项历史性队列研究纳入了2008年4月至2016年6月期间接受种植体支持的全牙弓即刻负重修复治疗且佩戴即刻修复体超过6个月的患者。查阅病历以获取患者的一般信息、种植体信息、修复体信息以及修复体并发症的详细情况。采用COX比例风险模型分析修复体折断的潜在风险因素。共纳入114例患者,平均年龄为(56.7±10.2)岁,共144个修复体。即刻修复体的中位佩戴时间为17.6个月。62例(54%)患者发生修复体并发症,其中30例经历不止一次并发症。人工牙折断在前牙区更常见,而树脂基托折断在后牙区更常见。即刻修复体在第一年折断的可能性较高,但在随后几年有所下降。COX回归分析显示,纤维增强(=0.486,0.017)和对颌牙列坚硬(=2.272,0.016)与修复体折断显著相关。种植体支持的全牙弓即刻修复体的长期功能导致修复体并发症发生率较高,以修复体折断为最常见并发症,且第一年折断概率最高。纤维增强丙烯酸即刻修复体在对颌为可摘局部义齿修复的情况下可能功能良好。

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