Masaki Chihiro, Kondo Yusuke, Tomoeda Kei, Nodai Tomotaka, Munemasa Takashi, Mukaibo Taro, Hosokawa Ryuji
Division of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan.
Jpn Dent Sci Rev. 2024 Dec;60:120-127. doi: 10.1016/j.jdsr.2024.01.002. Epub 2024 Feb 23.
Dental implants have been widely used with success, but long-term usage sometimes leads to implant loss. The purpose of this review was to summarize the etiology of early and late failure requiring dental implant removal and the treatment strategies for the removal of failed implants and reimplantation. Early failures are often caused by patient-related factors, such as smoking, diabetes, radiotherapy, bone quality, and periodontitis of the remaining natural teeth. The most common cause of late failure is peri-implantitis, followed by implant fracture and implant malpositioning. Implants should be removed if they are mobile or if their superstructure cannot be maintained (e.g., implant fracture). For peri-implantitis, implant removal should be determined based on the patient's age and esthetic needs, the implant site, and the severity of bone loss. Many reports have been published on implant removal techniques. The reverse torque technique should always be the first choice because of its low invasiveness. The weighted survival rate for the replacement of failed implants is 86.3%, with a much lower survival rate after the second or subsequent implantations. Therefore, patient-specific problems, such as smoking habits and bruxism, should be checked before reimplantation and controlled to the greatest extent possible.
牙种植体已被广泛成功应用,但长期使用有时会导致种植体脱落。本综述的目的是总结需要拔除牙种植体的早期和晚期失败的病因,以及拔除失败种植体和重新种植的治疗策略。早期失败通常由患者相关因素引起,如吸烟、糖尿病、放疗、骨质质量以及剩余天然牙的牙周炎。晚期失败最常见的原因是种植体周围炎,其次是种植体骨折和种植体位置不当。如果种植体松动或其上部结构无法保留(如种植体骨折),则应将其拔除。对于种植体周围炎,应根据患者年龄、美学需求、种植体部位以及骨质流失的严重程度来决定是否拔除种植体。关于种植体拔除技术已经发表了许多报告。反向扭矩技术因其侵入性低应始终作为首选。失败种植体置换的加权生存率为86.3%,第二次或后续种植后的生存率则低得多。因此,在重新种植前应检查患者特有的问题,如吸烟习惯和磨牙症,并尽可能加以控制。