Kahm Se Hoon, Shim YoungHa, Yang SungEun
Department of Dentistry, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
Department of Conservative Dentistry, Seoul St. Mary's Dental Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2025 Aug 5;14(15):5507. doi: 10.3390/jcm14155507.
: The expansion of National Health Insurance (NHI) coverage for dental implants in South Korea has substantially increased implant placements among older adults. While implants offer functional and esthetic benefits, their lack of periodontal ligaments alters occlusal force distribution, potentially increasing biomechanical stress on adjacent or opposing teeth. This study aimed to investigate the association between the increased number of dental implants and the incidence of cracked teeth following the introduction of implant insurance. : A retrospective analysis was conducted using the Clinical Data Warehouse of Seoul St. Mary's Dental Hospital. Patients who underwent molar crown restorations between 2014 and 2022 were included. The incidence and clinical features of cracked teeth were compared before (2014-2015) and after (2016-2022) the introduction of implant insurance. Statistical analyses assessed differences in symptom presentation, pulp status, and treatment outcomes. : Among 5044 molars restored with crowns, 1692 were diagnosed with cracks. The incidence of cracked teeth significantly increased after NHI coverage for implants (25.5% vs. 32.6%, < 0.001). Cases after insurance implementation showed fewer signs and symptoms at initial presentation (67.4% vs. 50.0%, < 0.001), reduced irreversible pulpitis (37.2% vs. 25.8%, < 0.001), and increased preservation of pulp vitality (46.9% vs. 57.8%, < 0.001). These shifts may reflect changes in occlusal adjustment practices and earlier clinical intervention. : The findings suggest a temporal link between increased implant placement and the rising incidence of cracked teeth. Implant-induced occlusal changes may contribute to this trend. Careful occlusal evaluation and follow-up are essential after implant placement, and further prospective studies are warranted to confirm causality and refine prevention strategies.
韩国国民健康保险（NHI）对种植牙覆盖范围的扩大，大幅增加了老年人的种植牙植入量。虽然种植牙具有功能和美观方面的优势，但其缺乏牙周韧带会改变咬合力分布，可能增加相邻或对颌牙齿的生物力学应力。本研究旨在调查种植牙保险推出后，种植牙数量增加与牙齿劈裂发生率之间的关联。
使用首尔圣母医院临床数据仓库进行回顾性分析。纳入2014年至2022年间接受磨牙冠修复的患者。比较了种植牙保险推出前（2014 - 2015年）和推出后（2016 - 2022年）牙齿劈裂的发生率及临床特征。统计分析评估了症状表现、牙髓状态和治疗结果的差异。
在5044颗接受冠修复的磨牙中，1692颗被诊断为劈裂。种植牙纳入NHI覆盖范围后，牙齿劈裂的发生率显著增加（25.5%对32.6%，<0.001）。保险实施后的病例在初次就诊时症状和体征较少（67.4%对50.0%，<0.001），不可逆性牙髓炎减少（37.2%对25.8%，<0.001），牙髓活力保存增加（46.9%对57.8%，<0.001）。这些变化可能反映了咬合调整实践的改变和更早的临床干预。
研究结果表明，种植牙植入量增加与牙齿劈裂发生率上升之间存在时间上的关联。种植牙引起的咬合变化可能导致了这一趋势。种植牙植入后，仔细的咬合评估和随访至关重要，有必要进行进一步的前瞻性研究以确认因果关系并完善预防策略。
