种植体早期失败病例回顾性分析

doi:10.19723/j.issn.1671-167X.2018.06.026

摘要/Abstract

摘要：

目的: 探讨种植体早期失败的相关因素、治疗方法及预后。方法: 收集自2000年1月至2016年12月于北京大学口腔医院门诊部颌面外科行种植修复的病例,比较早期失败组和未失败组在性别、年龄、吸烟情况、植入部位、是否埋入愈合以及使用骨替代物的区别,记录早期失败病例的发现时间、治疗方法和预后。统计学方法为χ ²检验和描述性分析。 结果: 早期失败组和未失败组在性别上的分布差异无统计学意义(P=0.692);年龄≥40岁者早期失败率(1.0%)明显高于年龄<40岁者(0.4%, P=0.033);吸烟者的早期失败率(1.3%)明显高于不吸烟者(0.3%, P<0.01);各个植入部位的早期失败情况差异无统计学意义(P=0.709)。同时进行植骨和安装愈合基台的早期失败率(1.1%)比非同时进行植骨和安装愈合基台的早期失败率(0.5%)高(P=0.039)。早期失败发生时间的中位数为30.5 d, 83.3%的种植体早期失败由医生发现。早期失败种植体均在发现失败时及时取出,其中26例再次种植修复,3例再次失败,其余23例顺利完成种植修复。结论: 种植体早期失败很可能发生在种植术后约1个月,与年龄≥40岁、吸烟、同时安装愈合基台和植入植骨材料等因素有关;大部分种植体早期失败是复查中发现的,失败病例再次种植的成功率可以预期。

关键词: 种植体, 早期失败, 骨结合

Abstract:

Objective: To analyze the risk factors of early dental implant failure,treatment and prognosis.Methods:Cases of dental implants in the first clinical division from January 2000 to December 2016 were selected according to inclusion criteria. The differences of gender,age,smoking,location of implants,healing abutments and bone graft were compared between early failed implants and success implants. The general conditions of early failure patients,the early failure occurrence time,treatment and prognosis were recorded. Statistical methods were χ ² test and descriptive analysis, P<0.05 had statistical significance. Statistical analysis software was IBM SPSS Statistics 19.0. Results:There were 36 patients with 36 early failed implants and 4 381 patients with 6 564 success implants. The rate of early dental implant failure was 0.8% at individual level and 0.5% at implant level. There was no significant difference in gender between the failed implants and success implants(P=0.692). The failure rate of the patients ≥40 years old (1.0%) was higher significantly than that of the patients <40 years old(0.4%, P=0.033). The failure rate of smokers(1.3%) was higher significantly than that of non-smokers(0.3%,P<0.01).There was no significant difference of early failure among four implant locations,which were anterior maxilla,posterior maxilla,anterior mandibular and posterior mandibula(P=0.709).The early failure of implants with bone graft and healing abutments at the same time (1.1%) was significantly higher than that of the implants with bone and healing abutments separately (0.5%,P=0.039)。Ten patents with early failed implants had general diseases,including 5 patients with diabetes,3 with hypertension and 2 with coronary heart disease. All the patients with general diseases were controlled well. The median of early failure occurrence time was 30.5 after implant operations. 83.3% early failure implants was found by dentists at re-examinations. All of the early failure implants were removed when they were found failed. Twenty-six early failure implant sites were inserted with implants again,of which 23 implants were successful.Conclusion:The early dental implant failure was possible to occur in one month after implants inserting. The possible risk factors were age≥40 years old,smoking and using bone graft and healing abutments at the same time. Most early dental implant failure was found by dentists at re-examinations. The implants should be removed when the early dental implant failure was found,which didn’t influence the later implantation.

Key words: Dental implants, Early failure, Osseointegration

中图分类号:

R782.12

张智勇,孟甜,陈全,刘文曙,陈宇寰. 种植体早期失败病例回顾性分析[J]. 北京大学学报（医学版）, 2018, 50(6): 1088-1091.

Zhi-yong△ ZHANG,Tian MENG,Quan CHEN,Wen-shu LIU,Yu-huan CHEN. Retrospective analysis of early dental implant failure[J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1088-1091.

图/表 1

表1

参考文献 14

[1]	邸萍, 林野, 李健慧 , 等. 单颌拔牙后即刻种植即刻修复的临床回顾研究[J]. 中华口腔医学杂志, 2013,48(4):216-222. doi: 10.3760/cma.j.issn.1002-0098.2013.04.006
[2]	Alsaadi G, Quirynen M, Komárek A , et al. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection[J]. J Clin Periodontol, 2007,34(7):610-617. doi: 10.1111/j.1600-051X.2007.01077.x pmid: 17433044
[3]	李厚轩, 闫福华 . 重度牙周炎的规范化诊疗[J]. 中国实用口腔科杂志, 2016,9(4):193-196.
[4]	Baqain ZH, Moqbel WY, Sawair FA . Early dental implant fai-lure: risk factors[J]. Br J Oral Maxillofac Surg, 2012,50(3):239-243. doi: 10.1016/j.bjoms.2011.04.074 pmid: 21612850
[5]	Chrcanovic BR, Kisch J, Albrektsson T , et al. Factors influencing early dental implant failures[J]. J Dent Res, 2016,95(9):995-1002. doi: 10.1177/0022034516646098 pmid: 27146701
[6]	Bornstein MM, Halbritter S, Harnisch H , et al. A retrospective analysis of patients referred for implant placement to a specialty clinic: indications, surgical procedures, and early failures[J]. Int J Oral Maxillofac Implants, 2008,23(6):1109-1116. doi: 10.1111/j.1741-2358.2008.00228.x pmid: 19216281
[7]	Figueiredo R, Camps-Font O, Valmaseda-Castellón E , et al. Risk factors for postoperative infections after dental implant placement: a case-control study[J]. J Oral Maxillofac Surg, 2015,73(12):2312-2318. doi: 10.1016/j.joms.2015.07.025 pmid: 26311462
[8]	陈晖, 周峰美, 顾晓霞 , 等. 个性化Bego种植体负重方案选择及稳定性影响因素[J]. 中国组织工程研究, 2014,18(8):1237-1243. doi: 10.3969/j.issn.2095-4344.2014.08.015
[9]	Meyer U, Wiesmann HP, Fillies T , et al. Early tissue reaction at the interface of immediately loaded dental implants[J]. Int J Oral Maxillofac Implants, 2003,18(4):489-499. doi: 10.1046/j.1365-2591.2003.00679.x pmid: 12938999
[10]	Ikebe K, Wada M, Kagawa R , et al. Is old age a risk factor for dental implants[J] ? Jpn Dent Sci Rev, 2009,45(1):59-64. doi: 10.1016/j.jdsr.2009.02.001
[11]	Chrcanovic BR, Albrektsson T, Wennerberg A . Smoking and dental implants: a systematic review and meta-analysis[J]. J Dent, 2015,43(5):487-498. doi: 10.1016/j.jdent.2015.03.003 pmid: 25778741
[12]	Ma L, Zwahlen RA, Zheng LW , et al. Influence of nicotine on the biological activity of rabbit osteoblasts[J]. Clin Oral Implants Res, 2011,22(3):338-342. doi: 10.1111/j.1600-0501.2010.02088.x pmid: 21561475
[13]	Koldsland OC, Scheie AA, Aass AM . The association between selected risk indicators and severity of peri-implantitis using mixed model analyses[J]. J Periodontol, 2011,38(3):285-292. doi: 10.1111/j.1600-051X.2010.01659.x pmid: 21158898
[14]	Brunski JB . Avoid pitfalls overloading and micromotions of intra-osseous implants[J]. Dent Implantol Update, 1993,4(10):77-81. pmid: 7919404

相关文章 15

[1]	孙菲,李思琪,危伊萍,钟金晟,王翠,胡文杰. 种植体周病非手术治疗中联合应用甘氨酸粉喷砂的临床效果评价[J]. 北京大学学报（医学版）, 2022, 54(1): 119-125.
[2]	李熠,尉华杰,邱立新. 种植体折裂的临床分型与临床治疗方案[J]. 北京大学学报（医学版）, 2022, 54(1): 126-133.
[3]	王铮,丁茜,高远,马全诠,张磊,葛兮源,孙玉春,谢秋菲. 氧化锆多孔表面显微形貌对成骨细胞增殖及分化的影响[J]. 北京大学学报（医学版）, 2022, 54(1): 31-39.
[4]	梁峰,吴敏节,邹立东. 后牙区单牙种植修复5年后的临床修复疗效观察[J]. 北京大学学报（医学版）, 2021, 53(5): 970-976.
[5]	岳兆国,张海东,杨静文,侯建霞. 数字化评估CAD/CAM个性化基台与成品基台影响粘接剂残留的体外研究[J]. 北京大学学报（医学版）, 2021, 53(1): 69-75.
[6]	张众,孟焕新,韩劼,张立,释栋. 软组织垂直厚度对牙周炎患者种植修复临床效果的影响[J]. 北京大学学报（医学版）, 2020, 52(2): 332-338.
[7]	释栋,曹婕,戴世爱,孟焕新. 植体周炎再生治疗短期疗效观察[J]. 北京大学学报（医学版）, 2020, 52(1): 58-63.
[8]	林春平,卢松鹤,朱浚鑫,胡洪成,岳兆国,唐志辉. 个性化根形种植体的螺纹形态对周围牙槽骨应力分布影响的三维有限元分析[J]. 北京大学学报（医学版）, 2019, 51(6): 1130-1137.
[9]	王倩,李丹,唐志辉. 上颌窦底内提升术同期种植窦内成骨的临床效果[J]. 北京大学学报（医学版）, 2019, 51(5): 925-930.
[10]	刘潇倩,陈秋雯,冯海兰,王兵,屈健,孙振,衡墨迪,潘韶霞. 无牙颌患者locator附着体种植覆盖义齿修复后口腔卫生维护的纵向研究[J]. 北京大学学报（医学版）, 2019, 51(1): 136-144.
[11]	吴敏节，邹立东，梁峰. 上前牙即刻种植即刻修复负载3年后软、硬组织变化的临床观察[J]. 北京大学学报(医学版), 2018, 50(4): 694-699.
[12]	张海东，张立，释栋，韩劼，闫夏，谢也斯，孟焕新. 锥形锁柱种植体用于因牙周炎缺牙患者修复的临床观察[J]. 北京大学学报(医学版), 2018, 50(2): 300-307.
[13]	刘婧寅，陈飞，葛严军，魏菱，潘韶霞，冯海兰. 选择性激光熔化种植体对早期骨矿化沉积率的影响[J]. 北京大学学报(医学版), 2018, 50(1): 117-122.
[14]	范少轻，周彦恒. 种植体支抗整体远中移动下颌牙列治疗骨性Ⅲ类错牙合的疗效评价[J]. 北京大学学报(医学版), 2017, 49(3): 531-539.
[15]	梁乃文,石磊,黄颖,邓旭亮. 不同形貌纯钛表面对人脐静脉内皮细胞生物学行为的影响[J]. 北京大学学报(医学版), 2017, 49(1): 43-048.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Items	Early failure,n	Success,n	Early failure rate/%	Chi-square	P
Gender(number of cases)
Male Female	19 17	2 167 2 214	0.9 0.8	0.157	0.692
Age of group(number of cases)
18-29 years old 30-39 years old 40-49 years old 50-59 years old >60 years old	3 3 12 10 8	501 968 1 029 1 170 713	0.6 0.3 1.2 0.8 1.1
Age of section(number of cases)
<40 years old ≥40 years old	6 30	1 469 2 912	0.4 1.0	4.566	0.033
Smoking(number of cases) Non-smoking(number of cases)	28 8	2 064 2 317	1.3 0.3	13.468	<0.01
Location(number of implants)
Anterior maxilla Posterior maxilla Anterior mandibular Posterior mandibular	8 12 2 14	1 094 1 959 388 3 123	0.7 0.6 0.5 0.4	1.384	0.709
Difference of healing(number of implants)
Healing abutment No healing abutment	22 14	4 041 2 523	0.5 0.6	0.003	0.956
Difference of bone graft(number of implants)
Bone graft No bone graft	13 23	1 703 4 861	0.8 0.5	1.923	0.165
Bone grafting and healing abutment(number of implants)
Simultaneously Separately	8 28	741 5 823	1.1 0.5	4.254	0.039