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Factors associated with the survival and marginal bone loss of dental implants: a 5-year retrospective study

임플란트의 생존과 변연골 소실에 영향을 미치는 인자들

  • Song, Eul-Rak (Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University) ;
  • Lee, Jae-Kwan (Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University) ;
  • Um, Heung-Sik (Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Se-Hwan (Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University) ;
  • Chang, Beom-Seok (Department of Periodontology, Research Institute for Oral Sciences, College of Dentistry, Gangneung-Wonju National University)
  • 송을락 (강릉원주대학교 치과대학 치주과학교실) ;
  • 이재관 (강릉원주대학교 치과대학 치주과학교실) ;
  • 엄흥식 (강릉원주대학교 치과대학 치주과학교실) ;
  • 박세환 (강릉원주대학교 치과대학 치주과학교실) ;
  • 장범석 (강릉원주대학교 치과대학 치주과학교실)
  • Received : 2016.09.09
  • Accepted : 2016.12.13
  • Published : 2016.12.30

Abstract

Purpose: The purpose of this study was to compare the long-term survival rate and peri-implant marginal bone loss related to multiple risk factors including the clinician's experience. Materials and Methods: Four hundred twenty implants in 146 patients, who had involved a supportive periodontal therapy program every 3 to 6 months and had follow up data for at least 5 years, were selected as the study group. Peri-implant marginal bone loss, data of demographic, implant and surgical characteristics were collected from peri-apical radiographs and chart review. Implant survival was regarded as the remaining with radiographic marginal bone level in excess of 50% of the fixture length for any reason. Results: The cumulative survival rate after 5 years of loading was 94.9%. In binary logistic regression analysis, smoking status (P = 0.033) and presence of spontaneous cover screw exposure (P < 0.001) were significantly related to 5-year survival of implants. In stepwise multiple regression analysis, smoking status (P < 0.001), type of abutment connection (P < 0.001) and implant surface (P = 0.033) were significantly related to peri-implant marginal bone level. And the year of resident was not statistically related to 5-year implant survival in simple logistic regression analysis (P = 0.171). Conclusion: Smoking status, spontaneous cover screw exposure, type of abutment connection and implant surface might influence the implant success. There was no significant correlation between the year of resident and implant failure.

목적: 이 연구의 목적은 임플란트의 생존율과 주위 변연골 수준을 후향적으로 평가하여, 술자의 임상적 경험을 포함한 요인들이 미치는 영향을 분석하고자 하였다. 연구 재료 및 방법: 2002년 1월부터 2009년 3월까지 강릉원주대학교치과병원 치주과에서 전공의가 2단계법으로 식립한 임플란트 중 5년 이상의 기록이 있는 146명의 420개 임플란트를 대상으로, 임플란트 탈락여부, 주위 골 소실량, 성별, 연령, 2형 당뇨, 흡연, 지대주 연결 형식, 표면 처리 방법, 직경, 식립 부위, 식립 당시 전공의 연차, 덮개 나사의 조기 노출, 보철학적 합병증, 동반된 골 이식 술식 등의 영향을 평가하였다. 결과: 최종 보철물 장착 후 5년간 누적생존율은 94.9% 이었다. 이원로지스틱회귀분석 결과, 흡연과 덮개 나사의 조기 노출이 실패율을 유의하게 증가시켰다. 다중회귀분석 결과, 흡연, 임플란트 지대주 연결 형식, 및 표면 처리 방법이 임플란트 주위 변연골 수준 변화에 유의한 영향을 주었다. 술자의 임상경험을 반영하기 위한 식립 당시의 전공의 수련 연차는 임플란트의 실패와 유의한 연관성은 보이지 않았다(P = 0.171). 결론: 흡연, 덮개 나사의 조기 노출, 지대주 연결 형식 및 표면 처리 방법이 임플란트의 성공과 유의한 상관관계를 보이는 것으로 생각된다.

Keywords

References

  1. Pjetursson BE, Zwahlen M, Lang NP. Quality of reporting of clinical studies to assess and compare performance of implant-supported restorations. J Clin Periodontol 2012;39:139-59. https://doi.org/10.1111/j.1600-051X.2011.01828.x
  2. Pjetursson BE, Tan K, Lang NP, Bragger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004;15:667-76. https://doi.org/10.1111/j.1600-0501.2004.01120.x
  3. Vandeweghe S, De Bruyn H. The effect of smoking on early bone remodeling on surface modified Southern Implants(R). Clin Implant Dent Relat Res 2011;13:206-14. https://doi.org/10.1111/j.1708-8208.2009.00198.x
  4. Rosen P, Clem D, Cochran D, Froum S, McAllister B, Renvert S, Wang HL. Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. J Periodontol 2013;84:436-43. https://doi.org/10.1902/jop.2013.134001
  5. Costa FO, Takenaka-Martinez S, Cota LO, Ferreira SD, Silva GL, Costa JE. Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. J Clin Periodontol 2012;39:173-81. https://doi.org/10.1111/j.1600-051X.2011.01819.x
  6. Pjetursson BE, Helbling C, Weber HP, Matuliene G, Salvi GE, Bragger U, Schmidlin K, Zwahlen M, Lang NP. Peri-implantitis susceptibility as it relates to periodontal therapy and supportive care. Clin Oral Implants Res 2012;23:888-94. https://doi.org/10.1111/j.1600-0501.2012.02474.x
  7. Bain CA. Implant installation in the smoking patient. Periodontol 2000 2003;33:185-93. https://doi.org/10.1046/j.0906-6713.2003.03315.x
  8. Hinode D, Tanabe S, Yokoyama M, Fujisawa K, Yamauchi E, Miyamoto Y. Influence of smoking on osseointegrated implant failure: a meta-analysis. Clin Oral Implants Res 2006;17:473-8. https://doi.org/10.1111/j.1600-0501.2005.01244.x
  9. Klokkevold PR, Han TJ. How do smoking, diabetes, and periodontitis affect outcomes of implant treatment? Int J Oral Maxillofac Implants 2007;22 Suppl:173-202.
  10. Strietzel FP, Reichart PA, Kale A, Kulkarni M, Wegner B, Kuchler I. Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis. J Clin Periodontol 2007;34:523-44. https://doi.org/10.1111/j.1600-051X.2007.01083.x
  11. Lambert PM, Morris HF, Ochi S. The influence of smoking on 3-year clinical success of osseointegrated dental implants. Ann Periodontol 2000;5:79-89. https://doi.org/10.1902/annals.2000.5.1.79
  12. Kumar A, Jaffin RA, Berman C. The effect of smoking on achieving osseointegration of surfacemodified implants: a clinical report. Int J Oral Maxillofac Implants 2002;17:816-9.
  13. Mellado-Valero A, Ferrer Garcia JC, Herrera Ballester A, Labaig Rueda C. Effects of diabetes on the osseointegration of dental implants. Med Oral Patol Oral Cir Bucal 2007;12:E38-43.
  14. Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: update on associations and risks. J Clin Periodontol 2008;35:398-409.
  15. Enkling N, Johren P, Klimberg T, Mericske-Stern R, Jervoe-Storm PM, Bayer S, Gulden N, Jepsen S. Open or submerged healing of implants with platform switching: a randomized, controlled clinical trial. J Clin Periodontol 2011;38:374-84. https://doi.org/10.1111/j.1600-051X.2010.01683.x
  16. Haas R, Mensdorff-Pouilly N, Watzek G, Mailath M, Lill W, Reichsthaler J, Frey G, Thornton B. Kaplan und Meier-Vergleichsanalyse von 3000 gesetzten implantaten. In: GOI gesellschaft fur orale implantologie. Jahrbuch fur Orale Implantologie. Berlin; Quintessenz; 1994. p. 213-25.
  17. Preiskel HW, Tsolka P. Treatment outcomes in implant therapy: the influence of surgical and prosthodontic experience. Int J Prosthodont 1995;8:273-9.
  18. Zoghbi SA, de Lima LA, Saraiva L, Romito GA. Surgical experience influences 2-stage implant os-seointegration. J Oral Maxillofac Surg 2011;69: 2771-6. https://doi.org/10.1016/j.joms.2011.03.031
  19. Kohavi D, Azran G, Shapira L, Casap N. Retrospective clinical review of dental implants placed in a university training program. J Oral Implantol 2004;30:23-9. https://doi.org/10.1563/1548-1336(2004)030<0023:RCRODI>2.0.CO;2
  20. Melo MD, Shafie H, Obeid G. Implant survival rates for oral and maxillofacial surgery residents: a retrospective clinical review with analysis of resident level of training on implant survival. J Oral Maxillofac Surg 2006;64:1185-9. https://doi.org/10.1016/j.joms.2006.04.014
  21. Zupnik J, Kim SW, Ravens D, Karimbux N, Guze K. Factors associated with dental implant survival: a 4-year retrospective analysis. J Periodontol 2011;82:1390-5. https://doi.org/10.1902/jop.2011.100685
  22. Chang M, Wennstrom JL, Odman P, Andersson B. Implant supported single-tooth replacements compared to contralateral natural teeth. Crown and soft tissue dimensions. Clin Oral Implants Res 1999;10:185-94. https://doi.org/10.1034/j.1600-0501.1999.100301.x
  23. Reddy MS, Mayfield-Donahoo T, Vanderven FJ, Jeffcoat MK. A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants. Clin Oral Implants Res 1994;5:229-38. https://doi.org/10.1034/j.1600-0501.1994.050406.x
  24. De Bruyn H, Vandeweghe S, Ruyffelaert C, Cosyn J, Sennerby L. Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri-implant health. Periodontol 2000 2013;62:256-70. https://doi.org/10.1111/prd.12004
  25. Cardaropoli G, Lekholm U, Wennstrom JL. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res 2006;17:165-71. https://doi.org/10.1111/j.1600-0501.2005.01210.x
  26. Manz MC. Factors associated with radiographic vertical bone loss around implants placed in a clinical study. Ann Periodontol 2000;5:137-51. https://doi.org/10.1902/annals.2000.5.1.137
  27. Roos J, Sennerby L, Lekholm U, Jemt T, Grondahl K, Albrektsson T. A qualitative and quantitative method for evaluating implant success: a 5-year retrospective analysis of the Branemark implant. Int J Oral Maxillofac Implants 1997;12:504-14.
  28. Heitz-Mayfield LJ, Huynh-Ba G. History of treated periodontitis and smoking as risks for implant therapy. Int J Oral Maxillofac Implants 2009;24 Suppl:39-68.
  29. Bain CA, Moy PK. The association between the failure of dental implants and cigarette smoking. Int J Oral Maxillofac Implants 1993;8:609-15.
  30. Wennstrom JL, Palmer RM. Consensus report of session C. In: Lang NP, Karring T, Lindhe J, editors. Proceedings of the 3rd European Workshop on Periodontology. Berlin; Quintessenz Verlags; 1999. p. 255-9.
  31. Berglundh T, Persson L, Klinge B. A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years. J Clin Periodontol 2002;29:197-212. https://doi.org/10.1034/j.1600-051X.29.s3.12.x
  32. Ekfeldt A, Christiansson U, Eriksson T, Linden U, Lundqvist S, Rundcrantz T, Johansson LA, Nilner K, Billstrom C. A retrospective analysis of factors associated with multiple implant failures in maxillae. Clin Oral Implants Res 2001;12:462-7. https://doi.org/10.1034/j.1600-0501.2001.120505.x
  33. Schwartz-Arad D, Dolev E. The challenge of endosseous implants placed in the posterior partially edentulous maxilla: a clinical report. Int J Oral Maxillofac Implants 2000;15:261-4.
  34. Koo KT, Lee EJ, Kim JY, Seol YJ, Han JS, Kim TI, Lee YM, Ku Y, Wikesjo UM, Rhyu IC. The effect of internal versus external abutment connection modes on crestal bone changes around dental implants: a radiographic analysis. J Periodontol 2012; 83:1104-9. https://doi.org/10.1902/jop.2011.110456
  35. Penarrocha-Diago MA, Flichy-Fernandez AJ, Alonso-Gonzalez R, Penarrocha-Oltra D, Balaguer-Martinez J, Penarrocha-Diago M. Influence of implant neck design and implant-abutment connection type on peri-implant health. Radiological study. Clin Oral Implants Res 2013;24:1192-200.
  36. Vazquez Alvarez R, Perez Sayans M, Gayoso Diz P, Garcia Garcia A. Factors affecting peri-implant bone loss: a post-five-year retrospective study. Clin Oral Implants Res 2015;26:1006-14. https://doi.org/10.1111/clr.12416
  37. Abrahamsson I, Berglundh T. Effects of different implant surfaces and designs on marginal bone level alterations: a review. Clin Oral Implants Res 2009;20:207-15. https://doi.org/10.1111/j.1600-0501.2009.01783.x