Negahdari Ramin, Ghoreishizadeh Arezou, Ghavimi Mohammad Ali, Soltanpour Atefeh, Bohlouli Sepideh
Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
J Adv Periodontol Implant Dent. 2021 Nov 24;13(2):61-68. doi: 10.34172/japid.2021.017. eCollection 2021.
Perforation of the soft tissues overlying the dental implant, resulting in early and spontaneous exposure of cover screws between stages I and II of the two-staged implant placement procedure, is a common problem that can disrupt the primary repair and osseointegration process. The present study aimed to investigate the prevalence of spontaneous exposure of cover screws in dental implants and identify the related risk factors.
The present retrospective, descriptive-analytical study enrolled 40 patients with 182 dental implants in the second stage of the implant placement procedure. Data on patient-related and implant-related classified variables were collected, and all the samples were examined for cover screw exposure based on the classification by Tal. First, the overall prevalence of cover screw exposure was calculated. Then, statistical analysis was performed using SPSS 24 to investigate the effect of different variables on this exposure. The chi-squared test was used at the bivariate level, while the logistic regression was used at the multivariate level.
Of 40 participants with 182 implants, 17 implants (9.3%) in 9 patients (22.5%) became exposed to the oral cavity. In terms of severity, Class I exposure was the most common with seven implants. Moreover, Class III was the least common with only one implant. Using the logistic regression analysis, we found significant relationships between the dental implant exposure and the variables of overlying mucosal thickness (OR=24.7, P≤0.001), the duration between tooth extraction and implant placement (OR=9.6, P=0.005), and implant location in the jaw (OR=3.8, P=0.033). Moreover, exposure was more common in the maxillary premolar area (22.5%) than in other locations. Also, there was a significant relationship between implant exposure and lateral augmentation (OR=0.20, P=0.044), indicating the higher risk of exposure in implants with lateral augmentation than those without augmentation.
Despite the limitations of this retrospective study, its results showed that three factors, including the overlying mucosal thickness of <2 mm, implant placement in fresh extraction sockets, and maxillary implants, especially at the location of maxillary premolars, were strong predictors of spontaneous implant exposure.
在两阶段种植体植入手术的第一阶段和第二阶段之间，覆盖种植体的软组织穿孔，导致覆盖螺丝早期自发暴露于口腔，这是一个常见问题，可能会干扰一期修复和骨整合过程。本研究旨在调查种植体覆盖螺丝自发暴露的发生率，并确定相关危险因素。
本回顾性描述性分析研究纳入了40例患者的182颗处于种植体植入手术第二阶段的种植体。收集了与患者和种植体相关的分类变量数据，并根据Tal的分类方法对所有样本进行覆盖螺丝暴露情况检查。首先，计算覆盖螺丝暴露的总体发生率。然后，使用SPSS 24进行统计分析，以研究不同变量对这种暴露的影响。双变量水平使用卡方检验，多变量水平使用逻辑回归分析。
在40名有182颗种植体的参与者中，9名患者（22.5%）的17颗种植体（9.3%）暴露于口腔。在严重程度方面，I类暴露最为常见，有7颗种植体。此外，III类暴露最不常见，只有1颗种植体。通过逻辑回归分析，我们发现种植体暴露与覆盖黏膜厚度变量（OR=24.7，P≤0.001）、拔牙与种植体植入之间的时间间隔（OR=9.6，P=0.005）以及种植体在颌骨中的位置（OR=3.8，P=0.033）之间存在显著关系。此外，在上颌前磨牙区域暴露比在其他位置更常见（22.5%）。而且，种植体暴露与侧向植骨之间存在显著关系（OR=0.20，P=0.044），表明进行侧向植骨的种植体比未进行植骨的种植体暴露风险更高。
尽管这项回顾性研究存在局限性，但其结果表明，包括覆盖黏膜厚度小于2mm、在新鲜拔牙窝植入种植体以及上颌种植体，尤其是在上颌前磨牙位置这三个因素，是种植体自发暴露的有力预测因素。
