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同一部位种植体反复失败:一项回顾性临床研究。

Repeated failure of implants at the same site: a retrospective clinical study.

作者信息

Kang Dong-Woo, Kim So-Hyun, Choi Yong-Hoon, Kim Young-Kyun

机构信息

1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea.

2Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Maxillofac Plast Reconstr Surg. 2019 Jul 10;41(1):27. doi: 10.1186/s40902-019-0209-1. eCollection 2019 Dec.

Abstract

BACKGROUND

Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation.

METHODS

Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated.

RESULTS

A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each).The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed re-implantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%).Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months.

CONCLUSIONS

Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.

摘要

背景

种植体正成为牙齿缺失修复的首选。尽管其成功率较高,但仍因多种原因出现失败情况。本研究的目的是分析同一部位反复失败的原因以及再次种植的结果。

方法

选取2004年至2017年期间在首尔国立大学盆唐医院口腔颌面外科同一部位(同一拔牙区域)经历两次或更多次种植手术失败的13例患者(11例男性,2例女性,平均年龄60±9.9岁)。回顾了种植体的类型、部位、直径和长度;失败的时间和估计原因;以及X线片。对数据进行回顾性收集和分析,并评估当前状况。

结果

共有14枚种植体在同一部位失败超过两次。12枚种植体植入上颌,2枚植入下颌。上颌磨牙区是最常见的失败部位(57.1%),其次是下颌磨牙、上颌前部和前磨牙区(各占14.3%)。首次失败最常发生在修复治疗后(35.7%),加载后平均失败时间为3.8个月。10例进行了即刻再次种植,另外4例平均在3.9个月后进行了延期再次种植。第二次失败最常发生在修复治疗后(42.9%),加载后平均31个月;在愈合期(42.9%);以及在进行修复期(14.3%)。3例(21.4%)的治疗方案改为种植桥,另外11例进行了另一次种植手术(78.6%)。最后,共有9枚种植体(64.3%)存活,平均功能期为60个月。

结论

由于过载、感染和其他未明确的原因,种植体可能在同一部位反复失败。患者的年龄和性别以及种植体植入位置似乎与反复失败有关。种植体类型、骨增量和使用的骨材料相关性较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ecc/6616583/d2e27007f517/40902_2019_209_Fig1_HTML.jpg

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