대한치과의사협회지 (The Journal of the Korean dental association)

  • 제53권5호
  • /
  • Pages.326-347
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  • 2015
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  • 0376-4672(pISSN)
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  • 2713-7961(eISSN)
대한치과의사협회 (The Korean Dental Association)
권호 표지

노인 환자에서 임플란트의 생존율에 대한 후향적 연구

A retrospective study on survival rates of dental implants in elderly patients

  • Shin, Hee-Jong (Department of Periodontology, School of Dentistry, Chosun University) ;
  • Yu, Sang-Joun (Department of Periodontology, School of Dentistry, Chosun University) ;
  • Kim, Byung-Ock (Department of Periodontology, School of Dentistry, Chosun University)
  • 투고 : 2014.06.11
  • 심사 : 2015.04.09
  • 발행 : 2015.05.01
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초록

목적: 노인 환자에서 식립된 임플란트의 생존율을 조사하고 다양한 요인에 따라 생존율에 미치는 영향을 후향적으로 평가하고자 하였다. 재료 및 방법: 2001년 1월부터 2007년 12월까지 조선대학교 치과병원 치주과에 내원한 65세 이상 노인 환자 56명에게 식립된 138개의 임플란트를 대상으로 하였다.(남자 38명, 여자 18명, 평균 연령$69.38{\pm}3.91$세) 임플란트 생존율은 환자 성별 및 연령, 전신질환 유무, 치아 상실 원인, 식립 위치, 임플란트 직경 및 길이, 골질, 골이식 여부, 상부 보철물 유형에 따라 조사되었다. Kaplan-Meier survival analysis을 통해 각 요인에 따른 누적 생존율을 조사하였고, chi-square test를 통해 누적 생존율과 각각의 요인 간의 통계학적 유의성을 평가하였다. 결과: 보철물 시적 후 5 ~ 140개월 간 추적 관찰을 시행하였다. 65세 이상 노인 환자 56명에게 식립된 총 138개의 임플란트 중 추적 관찰 기간 동안 5개의 임플란트가 실패하였다. 그 중 63개의 임플란트는 환자가 정기적인 내원 약속에 응하지 않아 도중에 조사대상에서 제외되었으며, 결과적으로 5년간 누적 생존율은 94.9%였다. 임플란트 생존율에 영향을 미치는 다양한 요인 중 골질 (P=0.037) 및 상부 보철물 유형 (P=0.015) 간에 누적 생존율이 통계적으로 유의한 차이가 있었다. 그외 연령, 성별, 전신질환 유무, 치아상실 원인, 식립 위치, 임플란트 직경 및 길이, 골이식 유무 관련 요인과 누적 생존율 사이에는 통계적으로 유의한 차이가 없었다. 결론: 여러 한계가 있었지만 노인 환자의 무치악 부위에 있어 임플란트는 장기간에 걸쳐 예지성 있고 받아들여질 만한 치료이면서 적은 합병증과 실패율을 가진다.

키워드

참고문헌

  1. Statistics Korea. Estimated future population. 2010.
  2. el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part I. Implant Dent 1999;8:173-185. https://doi.org/10.1097/00008505-199908020-00011
  3. el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part II. Implant Dent 1999;8:265-277. https://doi.org/10.1097/00008505-199903000-00008
  4. de Baat C. Success of dental implants in elderly people - a literature review. Gerodontology 2000;17:45-48. https://doi.org/10.1111/j.1741-2358.2000.00045.x
  5. Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP, Belser UC, Lang NP. Longterm evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multicenter study with 2359 implants. Clin Oral Implants Res 1997;8:161-172. https://doi.org/10.1034/j.1600-0501.1997.080302.x
  6. Cochran DL, Buser D, ten Bruggenkate CM, Weingart D, Taylor TM, Bernard JP, Peters F, Simpson JP. The use of reduced healing times on ITI implants with a sandblasted and acid-etched (SLA) surface: early results from clinical trials on ITI SLA implants. Clin Oral Implants Res 2002;13:144-153. https://doi.org/10.1034/j.1600-0501.2002.130204.x
  7. Lekholm U, Zarb GA. Patient selection and preparation. In: Br?nemark PI, Zarb GA, Albrektsson T, editors. Tissue-Integrated Prostheses: Osseointegration in Clinical Dentistry. Chicago: Quintessence; 1985. p.199-209.
  8. Albrektsson T, Zarb GA, Worthington P, Ericsson AR. The long-term efficacy of currently used dental implants: A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:11-25.
  9. Zarb GA, Albrektsson T. Consensus report: towards optimized treatment outcomes for dental implants. J Prosthet Dent 1998;80:641-648. https://doi.org/10.1016/S0022-3913(98)70048-4
  10. van Steenberghe D, Quirynen M, Naert I. Survival and success rates with oral endosseous implants. In; Proceedings of the 3rd European Workshop on Periodontology. Berlin: Quintessence; 1999. p.242-254.
  11. Higuchi KW, Folmer T, Kultje C. Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. J Oral MaxillofacSurg 1995;53:264-268. https://doi.org/10.1016/0278-2391(95)90222-8
  12. Schwartz-Arad D, Laviv A, Levin L. Failure causes, timing, and cluster behavior: an 8-year study of dental implants. Implant Dent 2008;17:200-207. https://doi.org/10.1097/ID.0b013e3181777906
  13. Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failure rates and associated risk factors. Int J Oral Maxillofac Implants 2005;20:569-577.
  14. Holahan CM, Koka S, Kennel KA, Weaver AL, Assad DA, Regennitter FJ, Kademani D. Effect of osteoporotic status on the survival of titanium dental implants. Int J Oral Maxillofac Implants 2008;23:905-910.
  15. Fiorellini JP, Chen PK, Nevins M, Nevins ML. A retrospective study of dental implants in diabetic patients. Int J Periodontics Restorative Dent 2000;20:366-373.
  16. Farzad P, Andersson L, Nyberg J. Dental implant treatment in diabetic patients. Implant Dent 2002;11:262-267. https://doi.org/10.1097/00008505-200207000-00011
  17. Ellegaard B, Baelum V, Karring T. Implant therapy in periodontally compromised patients. Clin Oral Implants Res 1997;8:180-188. https://doi.org/10.1034/j.1600-0501.1997.080304.x
  18. Karoussis IK, Salvi GE, Heitz-Mayfield LJ, Bragger U, Hammerle CH, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res 2003;14:329-339. https://doi.org/10.1034/j.1600-0501.000.00934.x
  19. Bryant SR. The effects of age, jaw site, and bone condition on oral implant outcomes. Int J Prosthodont 1998;11:470-490.
  20. 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;8:400-408.
  21. Kim SH, Kim BO, Han KY. A clinical study on the periodontal status of the patient with diabetes mellitus. J Korean AcadPeriodontol 1993;23:27-36.
  22. Ivanoff CJ, Grondahl K, Sennerby L, Bergstrom C, Lekholm U. Influence of variations in implant diameters: a 3- to 5-year retrospective clinical report. Int J Oral Maxillofac Implants 1999;14:173-180.
  23. Friberg B, Grondahl K, Lekholm U, Br?nemark PI. Long-term follow-up of severly atrophic edentulous mandibles reconstructed with short Branemark implants. Clin Implant Dent Relat Res 2000;2:184-189. https://doi.org/10.1111/j.1708-8208.2000.tb00116.x
  24. Deporter D, Pilliar RM, Todescan R, Watson P, Pharoah M. Managing the posterior mandible of partially edentulous patients with short, poroussurfaced dental implants: Early data from a clinical trial. Int J Oral Maxillofac Implants 2001;16:653-658.
  25. Brocard D, Barthet P, Baysse E, Duffort JF, Eller P, Justumus P, Marin P, Oscaby F, Simonet T, Benqu? E, Brunel G. A multicenter report on 1,022 consecutively placed ITI implants: a 7-year longitudinal study. Int J Oral Maxillofac Implants 2000;15:691-700.
  26. Lazzara R, Siddiqui AA, Binon P, Feldman SA, Weiner R, Phillips R, Gonshor A. Retrospective multicenter analysis of 3i endosseous dental implants placed over a five-year period. Clin Oral Implants Res 1996;7:73-83. https://doi.org/10.1034/j.1600-0501.1996.070109.x
  27. Holahan CM, Wiens JL, Weaver A, Assad D, Koka S. Relationship between systemic bone mineral density and local bone quality as effectors of dental implant survival. Clin Implant Dent Relat Res 2011;13:29-33. https://doi.org/10.1111/j.1708-8208.2009.00206.x
  28. Becktor JP, Isaksson S, Sennerby L. Survival analysis of endosseous implants in grafted and nongrafted edentulous maxillae. Int J Oral Maxillofac Implants 2004;19:107-115.
  29. 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.
  30. Pjetursson BE, Bragger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res 2007;18:97-113. https://doi.org/10.1111/j.1600-0501.2007.01439.x
  31. Salonen MA, Oikarinen K, Virtanen K, Pernu H. Failures in the osseointegration of endosseous implants. Int J Oral Maxillofac Implants 1993;8:92-97.
  32. Pikner SS, Grondahl K, Jemt T, Friberg B. Marginal bone loss at implants: a retrospective, long-term follow-up of turned br?nemark system implants. Clin Implant Dent Relat Res 2009;11:11-13. https://doi.org/10.1111/j.1708-8208.2008.00092.x
  33. Bryant SR, Zarb GA. Crestal bone loss proximal to oral implants in older and younger adults. J Prosthet Dent 2003;89:589-597. https://doi.org/10.1016/S0022-3913(03)00199-9
  34. Engfors I, Ortorp A, Jemt T. Fixed implantsupported prostheses in elderly patients: a 5-year retrospective study of 133 edentulous patients older than 79 years. Clin Implant Dent Relat Res 2004;6:190-198. https://doi.org/10.1111/j.1708-8208.2004.tb00035.x
  35. Al Jabbari Y, Nagy WW, Iacopino AM. Implant dentistry for geriatric patients: a review of the literature. Quintessence Int 2003;34:281-285.
  36. Albrektsson T, Donos N; Working Group 1. Implant survival and complications. The Third EAO consensus conference 2012. Clin Oral Implants Res 2012;23:63-65. https://doi.org/10.1111/j.1600-0501.2012.02557.x