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影响骨质疏松或骨质减少患者植入物存活及边缘骨丢失的预后因素。

Prognostic factors influencing implant survival and marginal bone loss in patients with osteoporosis or osteopenia medication.

作者信息

Lee Sun-A, Yi Yang-Jin, Won Seunghyun, Chang Na-Hee, Kim Jong-Hee

机构信息

Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2025 Feb 28;51(1):17-25. doi: 10.5125/jkaoms.2025.51.1.17.

Abstract

OBJECTIVES

To evaluate the factors that influence the survival of dental implants and marginal bone loss (MBL) in patients taking osteoporosis or osteopenia medication.

MATERIALS AND METHODS

This study included patients who underwent dental implant treatment after taking medication for osteoporosis or osteopenia. Electronic medical records were used to collect data of patient age, sex, age at osteoporosis or osteopenia diagnosis, types of medications, age at medication initiation, duration of medication before implant surgery, whether the medication was paused before surgery, paused duration of medication, implant survival status, and MBL before and after prosthetic treatment. Firth's logistic regression was used to analyze the relationships between each variable and implant survival as well as between MBL before and after prosthetic treatment.

RESULTS

Of the 267 patients, 111 with 209 implants were included in the study. The mean observation period was 57.9 months. The survival rate was 92.8% at the patient level and 96.2% at the implant level. No significant associations were found between implant survival and any of the variables examined. MBL before prosthetic treatment was significantly associated with use of receptor activator of nuclear factor-κB ligand (RANKL) inhibitors () and bone formation stimulators (). Comparing the concurrent and single use of bisphosphonates and RANKL inhibitors, only the use of RANKL inhibitors alone was significantly associated with MBL before prosthetic treatment (). MBL after prosthetic treatment was significantly associated with injection method among the routes of drug administration ().

CONCLUSION

The implant survival rate in patients undergoing medical treatment for osteoporosis or osteopenia was comparable to the general implant survival rate. MBL before prosthetic treatment was associated with type of anti-osteoporotic medication, whereas MBL after prosthetic treatment was correlated with drug administration route. Further studies with larger sample sizes are required.

摘要

目的

评估服用骨质疏松症或骨质减少症药物的患者中影响牙种植体存留率及边缘骨吸收(MBL)的因素。

材料与方法

本研究纳入了服用骨质疏松症或骨质减少症药物后接受牙种植治疗的患者。采用电子病历收集患者的年龄、性别、骨质疏松症或骨质减少症诊断时的年龄、药物类型、开始用药时的年龄、种植手术前用药持续时间、手术前是否停药、停药持续时间、种植体存留状况以及修复治疗前后的MBL等数据。采用Firth逻辑回归分析各变量与种植体存留率之间以及修复治疗前后MBL之间的关系。

结果

267例患者中,111例患者的209枚种植体被纳入研究。平均观察期为57.9个月。患者水平的存留率为92.8%,种植体水平的存留率为96.2%。未发现种植体存留与所检查的任何变量之间存在显著关联。修复治疗前的MBL与核因子κB受体活化因子配体(RANKL)抑制剂的使用及骨形成刺激剂的使用显著相关。比较双膦酸盐和RANKL抑制剂的联合使用和单独使用情况,仅单独使用RANKL抑制剂与修复治疗前的MBL显著相关。修复治疗后的MBL与给药途径中的注射方法显著相关。

结论

接受骨质疏松症或骨质减少症治疗的患者的种植体存留率与一般种植体存留率相当。修复治疗前的MBL与抗骨质疏松药物类型有关,而修复治疗后的MBL与给药途径相关。需要进行更大样本量的进一步研究。

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