위축된 상악구치부에서 두 개의 짧은 임플란트 지지형 단일치관의 임상연구

Two-short implant supported single molar restoration in atrophic posterior maxilla : a clinical study

  • 송호용 (춘천예치과의원) ;
  • 허윤혁 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소)
  • Song, Ho-Yong (Ye-dental clinic) ;
  • Heo, Yoon-Hyuk (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University)
  • 투고 : 2015.06.25
  • 심사 : 2015.08.25
  • 발행 : 2015.09.01

초록

Purpose: The aim of this retrospective study was to compare marginal bone loss and survival rates of double short implants(multiple implant) which had been installed and restored in severely atrophic maxillary molar site without a grafting procedure. Material and Method: The subjects were patients (90 patients, 180 implants) who had been installed double short implants in severely atrophic maxillary single molar site without bone augmentation procedure from 2006 to 2014 in dental clinic in Chuncheon city. Following data were collected from dental records and radiographic panoramic views: patient's age, gender, smoking status, implant site, timing of implant installation, residual ridge height. The correlation between those factors and survival rate and marginal bone loss were analyzed. Statistical analysis was performed using Chi-square test, Student's t- test and ANOVA. Result: Eleven implants in 6 patients failed and the cumulative survival rate was 93.9%. No significant differences were found in relation to the following factors: patient's age, gender, implant site, timing of implant installation (P> .05). There were significant differences in smoking status and residual ridge height(P< .05). The average follow-up time was $45{\pm}14.7months$. The mean marginal bone loss of survived 169 implants was $0.08{\pm}0.59mm$. Conclusion: Despite the short term outcomes, the survival rate of double short implants was comparable to normal length implants. This study demonstrated that placement of double short implants without the use of bone grafting procedure for severely atrophic posterior maxilla is a simple and predictable treatment procedure.

키워드

참고문헌

  1. Branemark PI, Adel R. Breine U, Hansson BO, Undstr?m J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Piast Reconstr Surg 1969;3:81-100.
  2. Branemark PI, Hansson BO, Adell R, Breine U, Lindstrom J, Hallen O, Ohman A. Osseointegrated impants in the treatment of the edentulous jaw, Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl 1977;16:1-132
  3. Aclel R, Lekholm U, Rockier S, 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
  4. Adell R. Lekholm U, Rockier S, BrBnemark PI. Longterm follow-up study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1990;5:347-59.
  5. Albrektsson T, Zarb G, Worthington P, Eriksson M. The long-term efficacy of currently used dental implant: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:11-25.
  6. Buser D, Mericske-Stern R, Uula K, Lang NP. Clinical experience with one-stage, non-submerged dental impants. Adv Dent Res 1999;13:153-61 https://doi.org/10.1177/08959374990130010501
  7. Albrektsson T, Sennerby L. State of the art in oral implants. J Clil Periodontal 1991; 18:471-81
  8. Albrektsson T, Isidor F. Consensus report of session IV In: Lang NP, Karring T, eds Proceedings of the 1st European Workshop on Periodontology. London: Quintessence, 1994:365-9.
  9. Van Steenberghe D, Qurynen, M, Naert I. Survival and success rates with oral endosseous imp ants. In Lang NP, Karring T, Undhe. J. eds. Proceedings of the 3rd European Workshop on Periodontology. Berlin : Quintessence, 1999:242754.
  10. Adell R, Lekholm U, Rockier B, Branemark PI, Lindhe J, Eriksson B, Sbordone L. Marginal tissue reactions at osseointegrated titanium fixtures(I), A 3-year longitudinal prospective study, Int J Oral Maxillofac Surg 1936;15:39-52.
  11. Buser D, Merske-Stern R, Bemard JP, Behke A, Behke N, Hirt HP, Belser UC, Lang NP. Long-term 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;8:161-72 https://doi.org/10.1034/j.1600-0501.1997.080302.x
  12. Schwartz-Arad D, Laviv A, Levil 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
  13. Kin SH, 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 Prosthadont 2010; 48: 28-40. https://doi.org/10.4047/jkap.2010.48.1.28
  14. Anderson DJ. Measurement of s tress in mastication. J Dent Res. 1956;35:644-73.
  15. Craig RG. Restorative dental material. 7thed. St Louis: Mosby, 1985:60
  16. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the sinus consensus of 1996, Int J oral maxillofac Implants 1998;13(suppl):11-45.
  17. Friberg B, Gtbndahl K, Lekholm U, Branemark P-I. Long-term follow-up of severely atrophic edentulous mandibules reconstructed with short branemark impants. Clin Impant Dent Rei at Res 2000;2:184-89. https://doi.org/10.1111/j.1708-8208.2000.tb00116.x
  18. Neves FD, Fones D, Berna rdes SR, Prado CJ. Fernandes Neto AJ. Int J Oral Maxillofac Implant 2006;21:86-93
  19. Pierrisnard L, Renaouard F, Renault P, Barquins M. Influence of implant length and bicortical anchorage on implants stress distribution. Clin Implant Dent Relat Res 2003;5:254-62 https://doi.org/10.1111/j.1708-8208.2003.tb00208.x
  20. Akca K, Cehreli MC, Iplikcioglu H. A comparison of three dimensional finite element stress analysis with in vivo strain gauge measurement on dental implants. Int J Prosthet 2002;15:115-21.
  21. Lum LB. A biomechanical rationale for the use of the short implants. J Oral Impiantol 1991;17:126-31.
  22. Lee EJ, Kim W, Choi SM, Oh NS. A systematic review of the survival rate on short implants. J Korean Acad Prosthodont 2009;47:457-62. https://doi.org/10.4047/jkap.2009.47.4.457
  23. Sato Y, Shindoi N, Hosokawa R, Tsuga K, Akagawa Y. Bbmechanical effects of double or wide implants for shgle molar replacement in the posterior mandibular region. J Oral Rehabil 2000,27:842-5 https://doi.org/10.1046/j.1365-2842.2000.00598.x
  24. Griffin TJ, Cheung WS. The use of short, wide implants in posterior areas with reduced bone height. A retrospective investigation. J Prosthet Dent 2004;92:139-44, https://doi.org/10.1016/j.prosdent.2004.05.010
  25. Becker W, Becker BE. Replacement of maxillary and mandibular molars with single endosseous implant restorations: A retrospective study. J Prosthet Dent 1995;74:51-5. https://doi.org/10.1016/S0022-3913(05)80229-X
  26. Sullivan DY. Wide implants for wide teeth. Dent Eoom 1994;84;84-3
  27. Balshi TJ, Wolfinger GJ. Two-implant-supported single molar replacement: Interdental space requirements and comparison to alternative options. Int J Periodontics Restorative Dent 1997;17:426-35
  28. Wolfinger GJ, Balshi TJ, Wulc D, Balshi SF. A Retrospective analysis of 125 single molar crowns supported by two implants. Long-term follow-up from 3 to 12 years. Int J Oral Maxillofac Implants 2011;26:148-53
  29. Romanos GE, Nentwig GH. Single molar replacement with a progressive thread design implant system A retrospective clinical report. Int J Oral Maxllofac Implants 2000;15:831-6.
  30. Zarb GA, AI rektsson T. Consensus report Towards optimized treatment outcomes for dental implants. J Prosthet Dent 1998;80:641 https://doi.org/10.1016/S0022-3913(98)70048-4
  31. Renouard F, Nisand D. Short implants in the severely resorbed maxilla: A 2-year retrospective clinical study. Clin Implant Dent Relat Res 2005;7(suppl 1);104-10 https://doi.org/10.1111/j.1708-8208.2005.tb00082.x
  32. Malo P, Nobre MDA, Rangert B. Short implants placed one-stage in maxillae and mandibles. A retrospective clinical study with 1 to 9 years of follow-up. Clin Implant Dent Relat Res 2007,9:15-21. https://doi.org/10.1111/j.1708-8208.2006.00027.x
  33. Ryu HS, Kim SJ, Park EJ. Kim MR. A retrospective study of the cumulative survival rate and change of peri-implant marginal bone around implnats associated with maxillary sinus augementation. J Korean Plead Prosthodont 2009,47:240-6. https://doi.org/10.4047/jkap.2009.47.2.240
  34. Wallace SS, Froum SJ. Effect of maxillary sinus augmentation on the survival end osseous dental implants. A systematic review. Ann Periodontol 2003;8:328-41 https://doi.org/10.1902/annals.2003.8.1.328
  35. Ivanoff CJ, Grongahl K, Bergstrom C, Lekholm U, Branemark PI. Influence of bicortical or monocortical anchorage on maxiIlary implant stability: A 15-year retrospective study of Braemark system implant. Int J Oral Maxillofac Impants 2000;15:103-10.
  36. Morgan MJ, James DF, Pillar R. Fracture of the fixture components of an osseointegrated implant. Int J Oral Maxilofac Implants 1993;28:1103-09.
  37. Saadoun AP, Sullivan DY, Kirschek M, LeGalI M. Single-tooth Implant management for success. Pract Periodontics Aesthet Dent 1934;16:78-82.
  38. Davarpanah M, Martinez H, Tecucianu JF, Alcoforado G, Etienne D, Celleti D. The self-tapping and ICE 3i implants. A prospective 3-year multicenter evaluation. Int J Oral Maxillofac Implants 2001;16:52-60,
  39. Scortecd GM, Misch CE, Benner KU. Implants and Restorative Dentistry. Los Angeles. House Cline, 2000;60.
  40. Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants. A systematic review and meta-analysis. J Dent 2015;43:487-98. https://doi.org/10.1016/j.jdent.2015.03.003
  41. Wadhwa D, Bey A, Hasija M, Moin S, Kumar A, Aman S, Sharma VK. Determination of level of nitro oxide in smoker and nonsmoker patients with chronic periodontitis. J Periodontal Implant Sci 2013;43:215-20, https://doi.org/10.5051/jpis.2013.43.5.215
  42. Tatli U, Damlar I, Erdogan O, Esen E. Effect of smoking on periirrplant health status and IL-$1{\beta}$, TNF-$\alpha$ and PGE2 levels In periimplant crevcular fluid: a cross-sectional study on well-maintained implant recall patients. Implant Dent 2013;22:519-24. https://doi.org/10.1097/ID.0b013e31829a1718
  43. Zinser MJ, Randelzhofer P, Kuiper L, De Lange GL. The predictors of implant failure after maxi lary sinus floor augmentation and reconstruction a prospective study of 1045 consecutive inr)ants. Oral Surg Oral Med Oral Pathol Radiol 2013;115:571-82 https://doi.org/10.1016/j.oooo.2012.06.015
  44. Ellegaard S, Baelum V, Kolsen-Petersen J. Nongrafted sinus implants In periodontally compromised patients: a time-ta-event analysis. Clin Oral lmpiants Res 2006;17:156-64. https://doi.org/10.1111/j.1600-0501.2005.01220.x
  45. Penarrocha-Oltra D, Dermarchi CL, Maestre-Ferrin L, Penarrocha-Diago M, Penarrocha-Diago M. Comparison of immediate and delayed implants in the maxillary molar region : A retrospective study of 123 implants. Int J Oral Maxilloiac Implants 2012;27:604-10
  46. Polizzi G, Grunder U, Goene R, Hatano N, Henry P, Jackson WJ, Kawarrura K, Renouard F, Rosenberg R, Triplett G, Werbitt M, Lithner B. Immediate and delayed implant placement into extraction sockets a 5-year report. Clin Implant Dent Relat Res 2000;2:93-9. https://doi.org/10.1111/j.1708-8208.2000.tb00111.x
  47. Horwitz J, Zuabi O, Peled M, Machtei EE. Immediate and delayed restoration of dental implants in periodontally susceptible patients, 1-year results. Int J Oral Maxillofac Implants, 2007;22:423-9
  48. Crespi R, Cappare P, Gherlone E. Immediate loading of dental implants placed in periodontally infected and non-infected sites: a 4-year follow-up clinical study. J Periodontol. 2010;81:1140-6. https://doi.org/10.1902/jop.2010.090666
  49. Alves CC, Correia AR, Neves M. Immediate implants and immediate loading in periodontally compromised patients-a 3-year prospective clinical study. Int J Periodontics Restorative Dent 2010;30:447-55
  50. Goodacre CJ, Bemal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prosheses. J Prosthet Dent. 2003;90:121-32. https://doi.org/10.1016/S0022-3913(03)00212-9
  51. Rosen PS, Summers R, Mellado JR, Salkin LM, Shanaman RH, Marks MH, Fugazzotto PA. The bone-added osteotome sinus floor elevation technique: multicenter retrospective report of consecutively treated patients. Int J Oral Maxillofac Implants. 1999; 14:853-8.
  52. Wallace SS, Froum SJ, Cho SC, Elian N, Monteiro D, Kim BS, Tarnow DP. Sinus augmentation utilizing anorganic bovine bone (Bio-Oss) with absorbable and nonabeorbable membranes placed over the lateral window. histomorphometric and clinical analyses. Int J Periodontics Restorative Dent. 2005;25:551-9
  53. Winter AA, Pollack AS, Odrich RB. Placement of implants in the severely atrophic posterior maxilla using localized management of the sinus foar a preliminary study. Int J Oral Maxillofac Implants. 2002;17:687-95.
  54. Lazzara RJ. The sinus elevation procedure in endosseous implant therapy. Curr Opin Periodontal. 1996;3:178-83
  55. Gabbert O, Koob A, Schmitter M, Rammelsberg P. Implants placed in combination with an internal sinus Iift without graft material, an analysis of short-term failure. J Clin Periodontol. 2009;36:177-83. https://doi.org/10.1111/j.1600-051X.2008.01357.x
  56. Vandeweghe S, De Ferrerre R, Tschakaloff A, De Bruyn H. A wide-body implant as an aternative for sinus lift or bone grafting. J Oral Maxillofac Surg. 2011;69:67-74
  57. Chang M, Wennstrom JL. Bone alterations at implant-supported FDPs in relation to inter-unit distances: a 5-year radiographic study. Clin Oral Implants Res. 2010;21:735-40. https://doi.org/10.1111/j.1600-0501.2009.01893.x