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

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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