Quintessence Int. 2024 Apr 25;55(4):296-303. doi: 10.3290/j.qi.b5013287.
This retrospective study analyzed radiographic bone levels of 10,871 dental implants in a cohort of 4,247 patients over a 22-year period. The objectives of the study were to assess and explore risk factors associated with the radiographic bone level of dental implants.
A longitudinal observational cohort study based on data collected from 1995 to 2019 was conducted on implants placed by a single periodontist. Inclusion criteria included both partially and fully edentulous sites. Exclusion criteria were patients who were considered ASA 3 or greater. Information on medical and dental status prior to implant placement such as diabetes and smoking were included in the analysis. Implant factors such as the implant characteristics (length and diameter) and surgical site were recorded. The outcome assessed was the prevalence of bone loss around implants and any associative factors related to the bone loss.
Overall, dental implants lost an average of 0.05 ± 0.38 mm of bone 2 to 3 years after placement and 0.21 ± 0.64 mm 8 years after placement. The soft tissue condition was evaluated using the Implant Mucosal Index (IMI), and bone loss around dental implants was significantly higher when bleeding on probing was multi-point and moderate, multi-point and profuse, and when infection with suppuration was recorded. The mean difference in bone level between smokers and nonsmokers was 0.26 mm (P < .01) over a 4-year period. A mean difference of 0.10 mm (P = .04) in bone loss over 4 years was found between those with an autoimmune disease compared to those without. The diameter of the implant and immediate loading of the dental implant did not influence the radiographic bone levels over time.
This large dataset of dental implants highlights predictive risk factors for bone loss around dental implants and the impact these risk factors have on the implant bone level. Consideration of these risk factors by both the dental team and the patient prior to dental implant placement will promote success of the treatment.
本回顾性研究分析了在 22 年期间，4247 名患者的 10871 颗牙种植体的放射影像学骨水平。本研究的目的是评估和探讨与牙种植体放射影像学骨水平相关的危险因素。
本研究为基于一位牙周病医生在 1995 年至 2019 年期间收集的数据进行的纵向观察性队列研究。纳入标准包括部分和完全无牙颌部位。排除标准为ASA 3 级或更高级别的患者。分析中包括种植体放置前的医疗和牙科状况信息，如糖尿病和吸烟。还记录了种植体因素，如种植体特征（长度和直径）和手术部位。评估的结果是种植体周围骨丢失的患病率以及与骨丢失相关的任何关联因素。
总体而言，牙种植体在放置后 2 至 3 年平均损失 0.05 ± 0.38mm 骨，在放置后 8 年平均损失 0.21 ± 0.64mm。使用种植体黏膜指数（IMI）评估软组织状况，当探诊时出现多点且中度、多点且大量出血以及存在化脓性感染时，牙种植体周围的骨丢失明显更高。在 4 年期间，吸烟者和不吸烟者的骨水平平均差异为 0.26mm（P <.01）。与无自身免疫性疾病的患者相比，患有自身免疫性疾病的患者在 4 年内的骨丢失平均差异为 0.10mm（P =.04）。种植体直径和牙种植体即刻负载对随时间变化的放射影像学骨水平没有影响。
本大量牙种植体数据集突出了预测牙种植体周围骨丢失的危险因素以及这些危险因素对种植体骨水平的影响。在进行牙种植体治疗之前，由牙科团队和患者共同考虑这些危险因素将促进治疗的成功。
