Miyamoto Ikuya, Takahashi Tetsu, Tanaka Tatsurou, Hirayama Bunichi, Tanaka Kenko, Yamazaki Toru, Morimoto Yasuhiro, Yoshioka Izumi
Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
Oral Radiol. 2018 Sep;34(3):199-207. doi: 10.1007/s11282-017-0299-3. Epub 2017 Aug 3.
The mechanism of late implant failure is unclear. This study examined the association between sclerosing cancellous bone images and the risk of late implant failures using multi-detector row computed tomography (CT) imaging data.
We performed a case-control study. The study group consisted of consecutive patients with implant failures treated at Kyushu Dental University between 2001 and 2016. CT data for late failure of 36 implants in 16 patients were available. The study cohort consisted of 16 patients with 36 late failed implants and 28 patients with 113 successful implants.
The mean survival rate was 6.9 months for early implant failure, 76.6 months for late failure with marginal bone resorption, inflammation symptoms, and so-called peri-implantitis, and 95.0 months for late failure caused by implant fracture. The mean HU value for cases in the control group was 507 compared with 1231 for cases with late failure implants. Logistic regression was used for analysis. There were signs of high radiodensity of peri-implant cancellous bone when comparing adjusted radiodensity per 100 HU using CT data (OR 2.35; 95% CI 1.73-3.20; p < 0.001).
Within the limits of our study, the presence of high radiodensity and cancellous bone consolidation on imaging may be related to risk factors for late implant failure. Therefore, CT images of the host cancellous bone status for observation of visible sclerosis could be a useful diagnostic indicator for late implant failure.
晚期种植体失败的机制尚不清楚。本研究使用多排螺旋计算机断层扫描（CT）成像数据，探讨了硬化性松质骨影像与晚期种植体失败风险之间的关联。
我们进行了一项病例对照研究。研究组由2001年至2016年在九州牙科大学接受种植体失败治疗的连续患者组成。可获得16例患者36枚种植体晚期失败的CT数据。研究队列包括16例有36枚晚期失败种植体的患者和28例有113枚成功种植体的患者。
早期种植体失败的平均生存率为6.9个月，伴有边缘骨吸收、炎症症状及所谓种植体周围炎的晚期失败为76.6个月，因种植体骨折导致的晚期失败为95.0个月。对照组病例的平均HU值为507，而晚期失败种植体病例为1231。采用逻辑回归进行分析。使用CT数据比较每100 HU调整后的放射密度时，种植体周围松质骨有高放射密度迹象（比值比2.35；95%可信区间1.73 - 3.20；p < 0.001）。
在我们的研究范围内，影像上高放射密度和松质骨硬化的存在可能与晚期种植体失败的风险因素有关。因此，观察可见硬化的宿主松质骨状态的CT图像可能是晚期种植体失败的有用诊断指标。
