Cai Bobo, Tong Zian, Qian Yinjie, Zhu Weijun, Lu Yifan, Si Misi
Graduate student, Graduate Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China.
Resident, Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Zhejiang, PR China.
J Prosthet Dent. 2023 Jan;129(1):125-130. doi: 10.1016/j.prosdent.2022.08.006. Epub 2022 Sep 9.
The outcome of implant-supported fixed complete dentures in edentulous patients with a history of periodontitis is unclear.
The purpose of this retrospective clinical study was to assess the clinical outcomes of immediate loaded fixed complete dentures in individuals with a history of periodontitis and to analyze risk factors related to implant failure.
A total of 642 implants (146 prostheses) in 119 patients were included. The follow-up period ranged from 2 to 7 years. Implant survival rates, marginal bone loss, mechanical complications, biologic complications, and patient satisfaction were evaluated. The Pearson chi-square test, independent samples t test, and multivariate generalized estimating equation were performed for statistical analysis (α=.05).
Eleven implants in 9 patients failed, leading to overall survival rates of 98.3% at the implant level and 92.4% at the patient level. The mean ±standard deviation marginal bone loss was 0.62 ±0.86 mm, and marginal bone loss did not differ significantly between axial and tilted implants (P>.05). Mechanical complications were detected in 55 (37.7%) definitive prostheses; biologic complications were detected in 318 (49.5%) implants. Smokers had a significantly lower survival rate than nonsmokers (odds ratio: 6.880, P=.013). Bruxers had a significantly higher incidence of mechanical complications than nonbruxers (P<.001).
The immediate loaded fixed complete denture supported by implants is a suitable treatment option for edentulous patients with a history of periodontitis, with high survival implant rates. Smoking is a risk factor for implant failure. Bruxism may increase the incidence of mechanical complications with implant-supported fixed complete dentures, and the overall biologic complication incidence is comparatively high.
在有牙周炎病史的无牙患者中，种植体支持的固定全口义齿的效果尚不清楚。
这项回顾性临床研究的目的是评估有牙周炎病史患者即刻负重固定全口义齿的临床效果，并分析与种植体失败相关的危险因素。
纳入119例患者共642枚种植体（146副修复体）。随访期为2至7年。评估种植体生存率、边缘骨吸收、机械并发症、生物并发症及患者满意度。采用Pearson卡方检验、独立样本t检验和多变量广义估计方程进行统计分析（α = 0.05）。
9例患者的11枚种植体失败，种植体水平的总生存率为98.3%，患者水平为92.4%。边缘骨吸收的均值±标准差为0.62±0.86 mm，轴向种植体和倾斜种植体之间的边缘骨吸收无显著差异（P>0.05）。55副（37.7%）最终修复体出现机械并发症；318枚（49.5%）种植体出现生物并发症。吸烟者的生存率显著低于不吸烟者（比值比：6.880，P = 0.013）。磨牙症患者机械并发症的发生率显著高于非磨牙症患者（P<0.001）。
种植体支持的即刻负重固定全口义齿是有牙周炎病史的无牙患者的合适治疗选择，种植体生存率高。吸烟是种植体失败的危险因素。磨牙症可能增加种植体支持的固定全口义齿机械并发症的发生率，总体生物并发症发生率较高。
