1Rotim Medical Center, Sesvete, Zagreb, Croatia; 2Department of Fixed Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 3Ruđer Bošković Institute, Zagreb, Croatia; 4Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia; 5Department of Oral Medicine and Periodontology, School of Medicine, University of Split, Split, Croatia; 6Department of Oral Medicine and Periodontology, School of Medicine, University of Rijeka, Rijeka, Croatia.
Acta Clin Croat. 2022 Feb;60(3):367-372. doi: 10.20471/acc.2021.60.03.05.
The etiopathogenesis of dental implant failure is multifactorial and may include numerous local and systemic factors, however, studies including both local and systemic factors are still lacking. Therefore, the aim of this study was to evaluate whether periodontal disease, oral hygiene index, i.e. bleeding on probing (BOP), full mouth plaque index (FMPI), smoking, systemic diseases, as well as implant characteristics (length and diameter) affect failure of implant-prosthodontic therapy. Data on 670 patients were retrieved in whom 1260 dental implants had been placed and followed-up for at least five to ten years. Categorical data were analyzed by the χ-test, whereas Mann-Whitney test was used for continuous variables (age, BOP and FMPI). The values of p<0.05 were considered significant. The effect of local and systemic factors on the success of implant-prosthodontic therapy was assessed by multiple logistic regression analysis. Forty-five (6.7%) patients had systemic diseases, of which diabetes mellitus was most common, followed by atherosclerosis, diabetes and atherosclerosis, diabetes mellitus type 1, lymphoma, and hepatitis C. One-third (33.4%) of the patients were smokers. Periodontal disease was present in 170 patients, while 500 patients were without periodontal disease. Nine implants were lost during the period of five years. There were no differences regarding the type of implant or type of connection to the prosthetic suprastructure. However, most of these patients had a periodontal disease. There were no significant differences in dental implant failure rates between smokers and non-smokers or between patients with and without systemic diseases. Furthermore, the results of this study showed that implant type (straight . tapered) and type of connection with prosthodontic appliance (cemented or screw retained) did not affect BOP and FMPI. In smokers, significant improvement of BOP and FMPI was noticed. Initially, smokers had a significantly worse BOP (0.0037) when compared to non-smokers; however, there were no differences regarding FMPI (p=0.4218) between the two groups. In patients with periodontal disease, improvement of BOP and FMPI was seen at 5-year follow-up and no significant differences were found when compared to patients without periodontal disease. There were no significant differences in BOP and FMPI between patients with and without diabetes at 5-year follow-up. Atherosclerosis had a significant negative effect on BOP, but not on FMPI at 5-year follow-up. It is concluded that periodontal disease had a significant impact on the implant-prosthodontic therapy.
种植体失败的病因学是多因素的，可能包括许多局部和全身因素，但仍缺乏同时考虑局部和全身因素的研究。因此，本研究旨在评估牙周病、口腔卫生指数（即探诊出血（BOP））、全口菌斑指数（FMPI）、吸烟、全身疾病以及种植体特征（长度和直径）是否会影响种植修复治疗的失败。本研究共纳入 670 名患者，共植入 1260 颗种植体，随访时间至少为 5 至 10 年。分类数据采用卡方检验，连续变量采用曼-惠特尼检验（年龄、BOP 和 FMPI）。p 值<0.05 被认为具有统计学意义。通过多因素逻辑回归分析评估局部和全身因素对种植修复治疗成功率的影响。45 名（6.7%）患者患有全身疾病，其中糖尿病最常见，其次为动脉粥样硬化、糖尿病伴动脉粥样硬化、1 型糖尿病、淋巴瘤和丙型肝炎。三分之一（33.4%）的患者吸烟。170 名患者患有牙周病，500 名患者无牙周病。在 5 年的随访期间，有 9 颗种植体失败。在种植体类型或与修复体上部结构的连接类型方面没有差异。然而，这些患者中大多数都有牙周病。吸烟者和非吸烟者、有全身疾病和无全身疾病的患者之间，种植体失败的发生率没有差异。此外，本研究结果表明，种植体类型（直型. 锥形）和与修复体的连接类型（粘接或螺丝固位）对 BOP 和 FMPI 没有影响。在吸烟者中，BOP 和 FMPI 显著改善。最初，与非吸烟者相比，吸烟者的 BOP 明显更差（0.0037）；然而，两组之间的 FMPI 没有差异（p=0.4218）。在牙周病患者中，5 年随访时 BOP 和 FMPI 得到改善，与无牙周病患者相比无显著差异。5 年随访时，糖尿病患者的 BOP 和 FMPI 无显著差异。动脉粥样硬化对 BOP 有显著的负面影响，但对 FMPI 无影响。结论是牙周病对种植修复治疗有显著影响。
