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임플란트 만족도와 삶의 질 간의 관련성에 대한 구조방정식모델 분석

Structural equation modeling for association between patient satisfaction and quality of life after implant surgery

  • 정선영 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 조진현 (경북대학교 치의학전문대학원 치과보철학교실) ;
  • 이규복 (경북대학교 치의학전문대학원 치과보철학교실) ;
  • 최연희 (경북대학교 치의학전문대학원 예방치과학교실) ;
  • 송근배 (경북대학교 치의학전문대학원 예방치과학교실)
  • Chung, Sun-Young (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Cho, Jin-Hyun (Department of Prosthodontics, School of Dentistry, Kyungpook National University) ;
  • Lee, Kyu-Bok (Department of Prosthodontics, School of Dentistry, Kyungpook National University) ;
  • Choi, Youn-Hee (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University) ;
  • Song, Keun-Bae (Department of Preventive Dentistry, School of Dentistry, Kyungpook National University)
  • 투고 : 2011.08.26
  • 심사 : 2011.10.10
  • 발행 : 2011.10.31

초록

연구 목적: 본 연구는 임플란트 식립에 대한 환자의 치료 만족도와 임플란트 전 후의 구강건강관련 삶의 질을 측정하고, 구조방정식모델을 이용하여 임플란트 후 환자가 느낀 치료 만족과 관련하여 어떠한 요인이 구강건강관련 삶의 질에 영향을 미치는지를 알아보고자 하였다. 연구 재료 및 방법: 대구광역시 소재 6개 개인치과의원에 임플란트 치료를 목적으로 내원한 257명의 환자를 대상으로 구조화된 설문지를 이용하여 임플란트 식립에 대한 만족도와 구강건강관련 삶의 질을 측정하였다. 주요 측정 항목에 응답하지 않은 11명을 제외한 246명을 최종분석대상에 포함시켰으며, AMOS 4.0 (SPSS Inc., Chicago, IL, USA)을 이용하여 임플란트 만족과 관련된 기능적 요인, 유지및관리요인, 비용 요인이 구강건강관련 삶의 질에 미치는 영향을 분석하였다. 결과:임플란트 수술 후 구강건강관련 삶의 질은 OHIP-14의 7개 영역 모두에서 수술 전에 비해 향상되었다. 임플란트 식립 후 환자들은 저작, 발음 그리고 심미 측면에서 만족도가 높았으나, 비용 측면에서 만족도가 매우 낮은 것으로 나타났다. 임플란트 식립 후 저작 능력과 심미성을 포함하는 기능적 요인과 유지 및 관리 요인에 대한 만족이 구강건강관련 삶의 질에 유의한 영향을 미치는 반면(P<.05), 비용 요인은 삶의 질에 유의한 영향을 미치지 않는 것으로 나타났다. 결론: 임플란트 수술에 따른 기능적 요인과 유지 및 관리 요인에 대한 만족이 높을수록 구강건강관련 삶의 질이 유의하게 높은 것으로 나타났다. 연구 결과를 통해 기존 연구에서 강조된 기능적 요인뿐만 아니라 유지 및 관리 요인의 중요성을 확인함으로써, 수술 후 환자에 대한 교육과 관리가 환자의 삶의 질 향상에 긍정적인 영향을 미친다는 점을 이론적 모델을 통해 제시하였다.

Purpose: This study was designed to measure patient satisfaction and oral health-related quality of life and to assess an association between patients' satisfaction and oral health-related quality of life after implant surgery by using structural equation modeling. Materials and methods: A total of 257 participants who visited 6 dental clinics located in Daegu city for the purpose of implant treatment participated in this study. Six months after completion of implant surgery, the patients' satisfaction and oral health-related quality of life were surveyed. The effect of factors associated with patients' satisfaction such as functions and aesthetics, maintenance and cost on oral health-related quality of life after implant surgery was analyzed using AMOS 4.0. Results: Oral health-related quality of life was improved in all dimensions of OHIP-14 after implant surgery. Functions and aesthetics as well as maintenance had a significant effect on oral health-related quality of life (P<.05), while cost was not a critical factor influencing oral health-related quality of life. Conclusion: High satisfaction with functional aspects and maintenance aspects significantly affected good quality of life. The result of this study supported the fact that education and management for patients after implant therapy were positively related to good quality of life based on a theoretical model.

키워드

참고문헌

  1. Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res 2003;14:166-72. https://doi.org/10.1034/j.1600-0501.2003.140205.x
  2. Sheiham A, Steele JG, Marcenes W, Tsakos G, Finch S, Walls AW. Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain. Community Dent Oral Epidemiol 2001;29:195-203. https://doi.org/10.1034/j.1600-0528.2001.290305.x
  3. Pjetursson BE, Karoussis I, Bu¨rgin W, Bra¨gger U, Lang NP. Patients' satisfaction following implant therapy. A 10-year prospective cohort study. Clin Oral Implants Res 2005;16:185-93. https://doi.org/10.1111/j.1600-0501.2004.01094.x
  4. Simonis P, Dufour T, Tenenbaum H. Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants. Clin Oral Implants Res 2010;21:772-7. https://doi.org/10.1111/j.1600-0501.2010.01912.x
  5. Korea Food and Drug Administration. Dental implant, Clear evidence of relacement from foreign to domestic manufacture. http://www.kfda.go.kr, 2010.
  6. Osstem Implant. Quarterly Financial Report Q3 2008. http://www.osstem. co.kr, 2008.
  7. Shin HS, Hong SY. The supply and demand for dentists in Korea. Health Soc Welf Rev 2007;27:81-102.
  8. Osstem Implant. Investor Relations in Korean. http://www.osstem. co.kr, 2010.
  9. Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res 2008;19:119-30. https://doi.org/10.1111/j.1600-0501.2007.01453.x
  10. Eckert SE, Choi YG, Sa′nchez AR, Koka S. Comparison of dental implant systems: quality of clinical evidence and prediction of 5-year survival. Int J Oral Maxillofac Implants 2005;20:406-15.
  11. Lee SY, Piao CM, Koak JY, Kim SK, Kim YS, Ku Y, Rhyu IC, Han CH, Heo SJ. A 3-year prospective radiographic evaluation of marginal bone level around different implant systems. J Oral Rehabil 2010;37:538-44. https://doi.org/10.1111/j.1365-2842.2010.02083.x
  12. Albrektsson T, Bra􀆆nemark PI, Hansson HA, Lindstro¨m J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981;52:155-70. https://doi.org/10.3109/17453678108991776
  13. Anderson JD. The need for criteria on reporting treatment outcomes. J Prosthet Dent 1998;79:49-55. https://doi.org/10.1016/S0022-3913(98)70193-3
  14. Eitner S, Wichmann M, Schlegel KA, Kollmannsberger JE, Nickenig HJ. Oral health-related quality of life and implant therapy: An evaluation of preoperative, intermediate, and posttreatment assessments of patients and physicians. J Craniomaxillofac Surg 2011 Apr 7. [Epub ahead of print]
  15. Abu Hantash RO, Al-Omiri MK, Al-Wahadni AM. Psychological impact on implant patients' oral health-related quality of life. Clin Oral Implants Res 2006;17:116-23. https://doi.org/10.1111/j.1600-0501.2005.01219.x
  16. Cibirka RM, Razzoog M, Lang BR. Critical evaluation of patient responses to dental implant therapy. J Prosthet Dent 1997;78: 574-81. https://doi.org/10.1016/S0022-3913(97)70008-8
  17. Jeong SH, Park JH, Ahn SH, Lee JH, Choi YH, Song KB. Assessing changes of the oral health related quality of Life following implant therapy. J Korean Acad Oral Health 2009;33: 585-96.
  18. Chung SY, Cho JH, Cho CH, Choi YH, Song KB. Factors associated with patient satisfaction and decision to get implant surgery. J Korean Acad Oral Health 2011;35:179-86.
  19. Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health 1994;11: 3-11.
  20. Locker D. Measuring oral health: a conceptual framework. Community Dent Health 1988;5:3-18.
  21. Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol 1997;25:284-90. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x
  22. Bae KH, Kim HD, Jung SH, Park DY, Kim JB, Paik DI, Chung SC. Validation of the Korean version of the oral health impact profile among the Korean elderly. Community Dent Oral Epidemiol 2007;35:73-9. https://doi.org/10.1111/j.1600-0528.2007.00331.x
  23. Heydecke G, Boudrias P, Awad MA, De Albuquerque RF, Lund JP, Feine JS. Within-subject comparisons of maxillary fixed and removable implant prostheses: Patient satisfaction and choice of prosthesis. Clin Oral Implants Res 2003;14:125-30. https://doi.org/10.1034/j.1600-0501.2003.140117.x
  24. Vermylen K, Collaert B, Linde′n U, Bjo¨rn AL, De Bruyn H. Patient satisfaction and quality of single-tooth restorations. Clin Oral Implants Res 2003;14:119-24. https://doi.org/10.1034/j.1600-0501.2003.140116.x
  25. Leles CR, Ferreira NP, Vieira AH, Campos AC, Silva ET. Factors influencing edentulous patients' preferences for prosthodontic treatment. J Oral Rehabil 2011;38:333-9. https://doi.org/10.1111/j.1365-2842.2010.02158.x
  26. Carlsson GE, Omar R. The future of complete dentures in oral rehabilitation. A critical review. J Oral Rehabil 2010;37:143-56. https://doi.org/10.1111/j.1365-2842.2009.02039.x
  27. Ikebe K, Hazeyama T, Ogawa T, Kagawa R, Matsuda K, Wada M, Gonda T, Maeda Y. Subjective values of different age groups in Japan regarding treatment for missing molars. Gerodontology 2011;28:192-6. https://doi.org/10.1111/j.1741-2358.2009.00357.x
  28. Pommer B, Zechner W, Watzak G, Ulm C, Watzek G, Tepper G. Progress and trends in patients' mindset on dental implants. II: implant acceptance, patient-perceived costs and patient satisfaction. Clin Oral Implants Res 2010;22:223-9.
  29. Bae BR. LISREL Structural equation modelling -comprehension, application and programming-. 2nd ed. Seoul: Cheong Ram; 2005. p. 21-40.
  30. Chang MT. A literature review on the survival rate of single implant- supported restorations. J Korean Acad Periodontol 2002; 32:69-87. https://doi.org/10.5051/jkape.2002.32.1.69
  31. McGrath C, Bedi R. Can dentures improve the quality of life of those who have experienced considerable tooth loss? J Dent 2001;29:243-6. https://doi.org/10.1016/S0300-5712(00)00063-4
  32. Heydecke G, Tedesco LA, Kowalski C, Inglehart MR. Complete dentures and oral health-related quality of life - do coping styles matter? Community Dent Oral Epidemiol 2004;32:297- 306. https://doi.org/10.1111/j.1600-0528.2004.00169.x
  33. Allen PF, McMillan AS. A longitudinal study of quality of life outcomes in older adults requesting implant prostheses and complete removable dentures. Clin Oral Implants Res 2003;14: 173-9. https://doi.org/10.1034/j.1600-0501.2003.140206.x
  34. Berretin-Felix G, Nary Filho H, Padovani CR, Machado WM. A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses. Clin Oral Implants Res 2008;19:704-8. https://doi.org/10.1111/j.1600-0501.2007.01451.x
  35. Awad MA, Locker D, Korner-Bitensky N, Feine JS. Measuring the effect of intra-oral implant rehabilitation on health-related quality of life in a randomized controlled clinical trial. J Dent Res 2000;79:1659-63. https://doi.org/10.1177/00220345000790090401
  36. Heydecke G, Locker D, Awad MA, Lund JP, Feine JS. Oral and general health-related quality of life with conventional and implant dentures. Community Dent Oral Epidemiol 2003;31: 161-8. https://doi.org/10.1034/j.1600-0528.2003.00029.x
  37. Thomason JM, Heydecke G, Feine JS, Ellis JS. How do patients perceive the benefit of reconstructive dentistry with regard to oral health-related quality of life and patient satisfaction? A systematic review. Clin Oral Implants Res 2007;18:168-88. https://doi.org/10.1111/j.1600-0501.2007.01461.x
  38. Ikebe K, Hazeyama T, Kagawa R, Matsuda K, Maeda Y. Subjective values of different treatments for missing molars in older Japanese. J Oral Rehabil 2010;37:892-9. https://doi.org/10.1111/j.1365-2842.2010.02123.x
  39. Zhao CR, Cho IH, Moon ES. A retrospective statistical analysis of dental implants. J Korean Acad Prosthodont 2009; 47:266-72. https://doi.org/10.4047/jkap.2009.47.3.266
  40. .Kim KW, Lee KS, Kang PS, Kim WS, Lee HK. Comparison of chewing ability and quality of life before and after the dental implantation. J Korean Acad Prosthodont 2009;47:215-21. https://doi.org/10.4047/jkap.2009.47.2.215

피인용 문헌

  1. Associated factors which influence satisfaction of dental implant patients and intention to revisit using structural equation model vol.13, pp.2, 2013, https://doi.org/10.13065/jksdh.2013.13.2.221
  2. 복합레진으로 제작한 인레이 보철물 구조에 따른 교합면 부위의 2차원 변연 적합도 및 내면 부위의 3차원 정확성 분석 vol.41, pp.1, 2011, https://doi.org/10.14347/kadt.2019.41.1.21