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颧种植体有无穿透颧骨外表面的颧周并发症:一项为期2年的回顾性研究。

Peri-zygomatic complications on zygomatic implants with or without penetrating the external surface of zygoma: A 2-year retrospective study.

作者信息

Yu Ziyang, Guo Houzuo, Han Weihua, Jiang Xi, Lin Ye

机构信息

Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease, Beijing, China.

出版信息

Clin Implant Dent Relat Res. 2024 Feb;26(1):197-205. doi: 10.1111/cid.13268. Epub 2023 Sep 6.

Abstract

OBJECTIVES

The main purpose of this retrospective study was to assess the difference in the incidence of peri-zygomatic complications (PZCs) when zygomatic implants (ZIs) penetrate or do not penetrate the external surface of zygoma.

MATERIALS AND METHODS

This study included 32 patients with edentulous maxillae or potentially edentulous maxillae undergo zygomatic implantation. The patients were divided into the penetration group (P-group) and the non-penetration group (N-group) according to whether the apex of implants penetrated the external surface of zygoma in postoperative CBCT. The extension length, the penetration section of the implants, and the skin thickness at the corresponding position were simultaneously measured. Clinical follow-up was conducted regularly until 2 years after surgery. The occurrence of PZCs (including peri-zygomatic infection, skin numbness, non-infectious pain, and foreign body sensation) was recorded. A mixed effect logistic model was used to compare the difference of complication rate between the P-group and the N-group, and odds ratio (OR) was calculated. Then identify the impact of the extension length, penetration section and skin thickness in P-group with the same model.

RESULTS

A total of 71 ZIs were implanted in 32 patients, including 37 implants in the P-group and 34 implants in the N-group. During the 2-year follow-up, a total of 13 implants occurred PZCs, with an overall complication rate of 18.3%. Thereinto, the incidence rate was 29.7% in the P-group, and 5.9% in the N-group (OR = 6.77). In P-group, there was a significant difference in complication rate of different extension lengths, while the penetration section and skin thickness had no statistical significance on the complication rate.

CONCLUSION

Under the limitation of this study, to minimize the risk of PZCs, ZI should be placed in a manner that avoids the apex penetrating the external surface of the zygoma.

摘要

目的

本回顾性研究的主要目的是评估颧骨种植体(ZIs)穿透或未穿透颧骨外表面时颧周并发症(PZCs)发生率的差异。

材料与方法

本研究纳入32例无牙上颌或潜在无牙上颌患者接受颧骨种植术。根据术后CBCT中种植体尖端是否穿透颧骨外表面,将患者分为穿透组(P组)和未穿透组(N组)。同时测量种植体的延伸长度、穿透部位以及相应位置的皮肤厚度。定期进行临床随访直至术后2年。记录PZCs的发生情况(包括颧周感染、皮肤麻木、非感染性疼痛和异物感)。采用混合效应逻辑模型比较P组和N组并发症发生率的差异,并计算比值比(OR)。然后用同一模型确定P组中延伸长度、穿透部位和皮肤厚度的影响。

结果

32例患者共植入71枚ZIs,其中P组37枚,N组34枚。在2年随访期间,共有13枚种植体发生PZCs,总并发症发生率为18.3%。其中,P组发生率为29.7%,N组为5.9%(OR = 6.77)。在P组中,不同延伸长度的并发症发生率有显著差异,而穿透部位和皮肤厚度对并发症发生率无统计学意义。

结论

在本研究的局限性下,为使PZCs风险最小化,颧骨种植体应避免尖端穿透颧骨外表面的方式植入。

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