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大骨缺损患者种植体的成功及种植体失败的风险因素分析:一项非随机回顾性队列研究。

Success of dental implants in patients with large bone defect and analysis of risk factors for implant failure: a non-randomized retrospective cohort study.

机构信息

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

出版信息

Clin Oral Investig. 2022 Mar;26(3):2743-2750. doi: 10.1007/s00784-021-04249-0. Epub 2021 Nov 16.

Abstract

OBJECTIVES

This study aimed to retrospectively investigate the success and survival rates of dental implants used for dentomaxillary prostheses at our hospital and the risk factors associated with large bone defects.

MATERIALS AND METHODS

A total of 138 external joint system implants used for dentomaxillary prostheses in 40 patients with large bone defects were included in this study. The alveolar bone at the site of implant insertion was evaluated using panoramic radiography and computed tomography. Various risk factors (demographic characteristics, dental status, and operative factors such as the employment of alveolar bone augmentation, the site, the length, and diameter of implants) for implant failure and complete implant loss were investigated using univariate and multivariate analyses. The associations between the variables and the success and survival rates of dental implants were analyzed using the multivariate Cox proportional hazard models.

RESULTS

The 10-year overall success and survival rates were 81.3% and 88.4% in this study. Multivariable analysis showed that the male sex (HR 6.22), shorter implants (≤ 8.5 mm) (HR 5.21), and bone augmentation (HR 2.58) were independent predictors of success rate. Bone augmentation (HR 5.14) and narrow implants (≤ 3.3 mm) (HR 3.86) were independent predictors of the survival rate.

CONCLUSION

Male sex, shorter or narrow implants, and bone augmentation were independent risk factors for dental implants used in dentomaxillary prostheses in patients with large bone defects.

CLINICAL RELEVANCE

Clinicians should consider these risk factors and pay close attention to the management of these patients.

摘要

目的

本研究旨在回顾性调查我院用于牙颌假体的牙种植体的成功率和存活率,以及与大骨缺损相关的危险因素。

材料与方法

本研究共纳入 40 例大骨缺损患者的 138 个外关节系统种植体用于牙颌假体。使用全景放射摄影和计算机断层扫描评估种植体插入部位的牙槽骨。使用单变量和多变量分析研究了种植体失败和完全丧失的各种危险因素(人口统计学特征、牙齿状况以及牙槽骨增强、植入部位、长度和直径等手术因素)。使用多变量 Cox 比例风险模型分析了变量与牙种植体成功率和存活率之间的关系。

结果

在本研究中,10 年的总体成功率和存活率分别为 81.3%和 88.4%。多变量分析显示,男性(HR 6.22)、较短的种植体(≤8.5mm)(HR 5.21)和骨增强(HR 2.58)是成功率的独立预测因素。骨增强(HR 5.14)和狭窄的种植体(≤3.3mm)(HR 3.86)是存活率的独立预测因素。

结论

男性、较短或较窄的种植体以及骨增强是大骨缺损患者牙颌假体中使用牙种植体的独立危险因素。

临床相关性

临床医生应考虑这些风险因素,并密切关注这些患者的管理。

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