구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제30권4호
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  • Pages.278-288
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  • 2014
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구

Retrospective study on survival rate of 2158 osseointegrated implants placed in 770 patients in Sanbon dental hospital of Wonkwang University

  • 선화경 (원광대학교 치과대학 산본치과병원 구강악안면외과) ;
  • 지영덕 (원광대학교 치과대학 산본치과병원 구강악안면외과)
  • Seon, Hwa-Gyeong (Derpartment of Oral and Maxillofacial Surgery, Sanbon Dental Hospital, College of Dentistry, Wonkwang University) ;
  • Chee, Young-Deok (Derpartment of Oral and Maxillofacial Surgery, Sanbon Dental Hospital, College of Dentistry, Wonkwang University)
  • 투고 : 2014.08.15
  • 심사 : 2014.11.14
  • 발행 : 2014.12.31
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초록

목적: 이 연구의 목적은 상악 및 하악의 완전 무치악 및 부분 무치악 부위에 식립된 골유착성 임플란트의 보철 전 초기 생존율 및 생존과 관련된 요소를 평가하고 실패를 야기하는 요인에 대해 알아보는 것이다. 연구 재료 및 방법: 2004년부터 2013년까지 770명의 환자에서 총 2158개의 골내 임플란트를 식립하였다. 임플란트의 소실과 환자의 연령 및 성별, 식립 위치, 임플란트 시스템, 길이 및 직경, 그리고 골이식 방법과의 연관성을 평가하기 위해 임상적 비교를 시행하였다. 결과: 임플란트 식립 위치에 따라 상악 전치부에서 98.23%, 상악 구치부 96.97%, 하악 전치부 97.85%, 하악 구치부 98.75%의 임플란트 생존율을 보였다(P < 0.05). 임플란트의 종류 및 표면처리 기법은 임플란트 생존율과 특이성을 보이지 않았다. 임플란트 매식체의 직경에 따라 3.0 mm 이하의 임플란트에서 100%, 3.0 - 3.5 mm 97.09%, 3.5 - 4.0 mm 98.19%, 4.0 - 4.5 mm 98.29%의 생존율을 보였고, 5.0 mm 이상의 직경을 가진 넓은 폭경의 임플란트에서 75%의 비교적 낮은 생존율을 보였다(P < 0.05). 임플란트 매식체의 길이에 따라 9 - 11 mm 및 11 - 13 mm의 길이를 가진 임플란트에서 각각 98.12% 및 98.17%의 높은 생존율을 보였으나 통계학적 유의성을 가지진 못하였다. 골이식술의 방법에 따라 상악동 골이식술을 단독으로 시행한 부위에서 임플란트 생존율은 89.05%, 골유도 재생술을 단독으로 시행한 경우 98.28%, 상악동 골이식술과 골유도 재생술을 동시에 시행한 경우 98.34%, 골이식술이 동반되지 않은 경우 99.28%의 생존율을 보였다(P < 0.05). 결론: 이번 연구에서 임플란트 식립 후 최종 보철물 시적 전 초기단계에서의 임플란트 생존율은 임플란트의 식립위치, 임플란트 매식체의 직경, 그리고 골이식 방법과 관련이 있었다. 이러한 결과에 따라 각각 상악 구치부, 5.0 mm 이상의 넓은 임플란트, 그리고 상악동 골이식술을 단독으로 시행한 부위에서 현저하게 낮은 생존율을 확인할 수 있었다.

Purpose: The aim of the study was to evaluate preprosthetic initial survival rate and factors associated with survival of osseointegrated implants placed in edentulous area of maxilla and mandible and to suspect the possible causes leading to failure. Materials and Methods: A total of 2158 endosseous implants that had been inserted between 2004 through 2013 were placed in 770 patients. The clinical comparisons were performed to evaluate implant loss in relation to age and gender of patients, position, system, length and diameter of implant, and bone graft technique. Results: According to position, the survival rates were 98.23% in maxillary anterior site, 96.98% in maxillary posterior site, 97.85% in mandibular anterior site and 98.76% in mandibular posterior site (P < 0.05). According to diameter of implant, the survival rates were 100% under 3.0 mm, 97.09% between 3.0 to 3.5 mm, 98.19% between 3.5 to 4.0 mm and 98.29% between 4.0 to 4.5 mm but relatively lower survival rate was 75% in 5.0 mm-over (P < 0.05). The survival rates of implants were 89.51%, 98.28%, 98.34% and 99.27% in the group with isolated sinus graft, with isolated GBR, with sinus graft and GBR simultaneously and without bone graft, especially (P < 0.05). Conclusion: This study establishes a relationship between survival rate of implant and position, diameter of implant system and bone graft technique. In conclusion, there were low survival rates in maxillary posterior site, in dental implants with wide diameter of 5 mm-over, and in the group with isolated sinus graft.

키워드

참고문헌

  1. Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969;3:81-100. https://doi.org/10.3109/02844316909036699
  2. Bergman B. Evaluation of the results of treatment with osseointegrated implants by the Swedish National Board of Health and Welfare. J Prosthet Dent 1983;50:114-5. https://doi.org/10.1016/0022-3913(83)90176-2
  3. Branemark PI, Hansson BO, Adell R, Breine U, Lindstrom J, Hallen O, Ohman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl 1977;16:1-132.
  4. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416. https://doi.org/10.1016/S0300-9785(81)80077-4
  5. Kim YS, Lee DK, Min SK, Lee J, Moon C. Clinical study on success rate of osseointegrated dental implants. J Korean Assoc Maxillofac Plast Reconstr Surg 2002;24:137-47.
  6. Esposito M, Grusovin MG, Coulthard P, Thomsen P, Worthington HV. A 5-year follow-up comparative analysis of the efficacy of various osseointegrated dental implant systems: a systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants 2005;20:557-68.
  7. Hong JY, Chae GJ, Jung UW, Kim CS, Cho KS, Chae JK, Kim CK, Choi SH. Retrospective studies of dental implant placement at each intraoral site and situation. J Korean Acad Periodontol 2007;37:805-24.
  8. Albrektsson T, Branemark PI, Hansson HA, Lindstrom 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
  9. van Steenberghe D, Quirynen M, Naert I. Survival and success rates with oral endosseous implants. In: Lang NP, Karring T, Lindhe J editors. Proceedings of the 3rd European Workshop on Periodontology. Berlin; Quintessence Publishing Co.; 1999. p. 242-54.
  10. Misch CE, Perel ML, Wang HL, Sammartino G, Galindo-Moreno P, Trisi P, Steigmann M, Rebaudi A, Palti A, Pikos MA, Schwartz-Arad D, Choukroun J, Gutierrez-Perez JL, Marenzi G, Valavanis DK. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent 2008;17:5-15. https://doi.org/10.1097/ID.0b013e3181676059
  11. Zarb GA, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: problems and complications encountered. J Prosthet Dent 1990;64:185-94. https://doi.org/10.1016/0022-3913(90)90177-E
  12. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology. Eur J Oral Sci 1998;106: 527-51. https://doi.org/10.1046/j.0909-8836..t01-2-.x
  13. Sussman HI. Endodontic pathology leading to implant failure: a case report. J Oral Implantol 1997;23:112-15.
  14. el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part I. Implant Dent 1999;8:173-85. https://doi.org/10.1097/00008505-199908020-00011
  15. Piattelli A, Scarano A, Piattelli M, Podda G. Implant periapical lesions: clinical, histologic, and histochemical aspects. A case report. Int J Periodontics Restorative Dent 1998;18:181-7.
  16. Lioubavina-Hack N, Lang NP, Karring T. Significance of primary stability for osseointegration of dental implants. Clin Oral Implants Res 2006;17:244-50. https://doi.org/10.1111/j.1600-0501.2005.01201.x
  17. Schwartz-Arad D, Laviv A, Levin L. Failure causes, timing, and cluster behavior: an 8-year study of dental implants. Implant Dent 2008;17:200-7. https://doi.org/10.1097/ID.0b013e3181777906
  18. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999;81:537-52. https://doi.org/10.1016/S0022-3913(99)70208-8
  19. Kim S, Kim SJ, Lee KW, Han DH. The effects of local factors on the survival of dental implants: a 19 year retrospective study. J Korean Acad Prosthodont 2010;48:28-40. https://doi.org/10.4047/jkap.2010.48.1.28
  20. Lazzara RJ, Testori T, Trisi P, Porter SS, Weinstein RL. A human histologic analysis of osseotite and machined surfaces using implants with two opposing surfaces. Int J Periodontics Restorative Dent 1999;19:117-29.
  21. Davies JE. Mechanism of endosseous integration. Int J Posthodont 1998;11:391-401.
  22. Haas R, Mensdorff-Pouilly N, Mailath G, Watzek G. Survival of 1920 IMZ implants followed for up to 100 months. Int J Oral Maxillofac Implants 1996;11:581-8.
  23. Scurria MS, Morgan ZV 4th, Guckes AD, Li S, Koch G. Prognostic variables associated with implant failure: a retrospective effectiveness study. In J Oral Maxillofac Implants 1998;13:400-6.
  24. Kim JS, Chang HH, Chang CH, Rhyu SH, Kang JH. Preprosthetic stage dental implant failure. J Korean Assoc Oral Maxillofac Surg 2001;27:178-83.
  25. Park KA, Jeong CW, Ryoo GH, Park KB, Kim YJ. Retrospective study of wide-diameter implants in maxillary & mandibular molar regions. J Korean Acad Periodontol 2007;37:825-38.
  26. Schwartz-Arad D, Laviv A, Levin L. Failure causes, timing, and cluster behavior: an 8-year study of dental implants. Implant Dent 2008;17:200-7. https://doi.org/10.1097/ID.0b013e3181777906
  27. Ivanoff CJ, Groendahl K, Sennerby L, Bergstrom C, Lekholm U. Influence of variation in implant diameters: a 3- to 5-year retrospective clinical report. Int J Oral Maxillofac Implants 1999;14:173-80.
  28. Jang JW, Ryoo KH, Chung HJ. Survival analysis of dental implants in maxillary and mandibular molar regions; a 4-5 year report. J Korean Acad Periodontol 2007;37:165-80.
  29. Friberg B, Ekestubbe A, Sennerby L. Clinical outcome of Branemark system implants of various diameters: a retrospective study. Int J Oral Maxillofac Implants 2002;17:671-7.
  30. Mijiritsky E, Mazor Z, Lorean A, Levin L. Implant diameter and length influence on survival: interim results during the first 2 years of function of implants by a single manufacturer. Implant Dent 2013;22:394-8. https://doi.org/10.1097/ID.0b013e31829afac0
  31. Langer B, Langer L, Herrmann I, Jorneus L. The wide fixture: a solution for special bone situations and a rescue for the compromised implant. Part 1. Int J Oral Maxillofac Implants 1993;8:400-8.
  32. Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res 2006;17 Suppl 2:35-51. https://doi.org/10.1111/j.1600-0501.2006.01349.x
  33. Shin SW, Bryant SR, Zarb GA. A retrospective study on the treatment outcome of wide-bodied implants. Int J Prosthodont 2004;17:52-8.
  34. Anner R, Better H, Chaushu G. The clinical effectiveness of 6 mm diameter implants. J Periodontol 2005;76:1013-5. https://doi.org/10.1902/jop.2005.76.6.1013
  35. Krennmair G, Waldenberger O. Clinical analysis of wide-diameter frialit-2 implants. Int J Oral Maxillofac Implants 2004;19:710-5.
  36. Becktor JP, Isaksson S, Sennerby L. Survival analysis of endosseous implants in grafted and nongrafted edentulous maxillae. Int J Oral Maxillofac Implants 2004;19:107-15.
  37. Fugazzotto PA. Success and failure rates of osseointegrated implants in function in regenerated bone for 72 to 133 months. Int J Oral Maxillofac Implants 2005;20:77-83.
  38. Corinaldesi G, Pieri F, Sapigni L, Marchetti C. Evaluation of survival and success rates of dental implants placed at the time of or after alveolar ridge augmentation with an autogenous mandibular bone graft and titanium mesh: a 3- to 8-year retrospective study. Int J Oral Maxillofac Implants 2009;24:1119-28.
  39. Mish CE. Bone character: second vital implant criterion. Dent Today 1998;7:39-40.
  40. Friberg B, Sennerby L, Roos J, Lekholm U. Identification of bone quality in conjunction with insertion of titanium implants. A pilot study in jaw autopsy specimens. Clin Oral Impants Res 1995;6:213-9. https://doi.org/10.1034/j.1600-0501.1995.060403.x
  41. Jensen OT. The sinus bone graft. 2nd ed. Chicago; Quintessence Publishing Co.; 2006. p. 178-81.
  42. Toffler M. Minimally invasive sinus floor elevation procedures for simultaneous and staged implant placement. N Y State Dent J 2004;70:38-44.
  43. Kim BJ, Lee JH. The retrospective study of survival rate of implants with maxillary sinus floor elevation. J Korean Assoc Oral Maxillofac Surg 2010;36:108-18. https://doi.org/10.5125/jkaoms.2010.36.2.108
  44. Boyne PJ. James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38:613-6.
  45. Summers RB. A new concept in maxillary implant surgery: the osteotome technique. Compendium 1994;15:152, 154-6, 158 passim; quiz 162.
  46. Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:8-17. https://doi.org/10.1016/S1079-2104(98)90391-2
  47. Tong DC, Rioux K, Drangsholt M, Beirne OR. A review of survival rates for implants placed in grafted maxillary sinuses using meta-analysis. Int J Oral Maxillofac Implants 1998;13:175-82.