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7년 이상 기능한 임플란트의 변연골 흡수와 생존율에 영향을 주는 요인

Factors associated with the survival rate and the marginal bone loss of dental implant over 7-years loading

  • 최정혁 (부산대학교 치의학전문대학원 치주과) ;
  • 고재권 (부산대학교 치의학전문대학원 치주과) ;
  • 권은영 (부산대학교 치의학전문대학원 치주과) ;
  • 주지영 (부산대학교 치의학전문대학원 치주과) ;
  • 이주연 (부산대학교 치의학전문대학원 치주과) ;
  • 김현주 (부산대학교 치의학전문대학원 치주과)
  • Choi, Jung-Hyeok (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Koh, Jae-kwon (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Kwon, Eun-Young (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Joo, Ji-Young (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Lee, Ju-Youn (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute) ;
  • Kim, Hyun-Joo (Department of Periodontology, School of Dentistry, Pusan National University, Dental Research Institute)
  • 투고 : 2018.03.09
  • 심사 : 2018.04.02
  • 발행 : 2018.06.30

초록

목적: 본 연구는 7년 이상 기능한 임플란트의 생존율과 평균 변연골 수준에 영향을 미치는 요인을 분석하고자 하였다. 연구 재료 및 방법: 92명의 환자에서 178개의 임플란트를 대상으로 하였다. 임상적 및 방사선학적 검사를 통해 임플란트 관련 요인(임플란트 직경, 임플란트 길이, 상부 보철물 고정 유무), 환자 관련 요인(성별, 흡연, 치태지수, 유지 치주치료 순응도) 및 수술 관련 요인(술자 숙련도, 골재생술 시행 유무)을 조사하였다. 구내 표준 방사선 촬영 이 후 각 임플란트의 근심 및 원심 변연골 수준은 이미지 분석 소프트웨어 프로그램을 사용하여 측정하였다. 결과: 임플란트의 생존율은 94.94%였고, 평균 변연골 흡수는 $0.89{\pm}1.05mm$였다. 임플란트 길이와 치태지수는 임플란트 생존율과 통계적으로 유의하였다(P < 0.05). 흡연과 골재생술 시행 유무는 변연골 흡수와 통계적으로 유의하였다(P < 0.05). 결론: 본 연구에서 7년 이상 기능한 임플란트는 양호한 생존율과 변연골 수준을 보였다. 임플란트의 장기적인 유지를 위해서는 임플란트의 길이, 치태조절에 유의하며 변연골 수준의 유지를 위해서는 골재생술의 신중한 적용, 흡연의 조절이 필요하다.

Purpose: The purpose of this study was to analyze the factors affecting the survival rate and the marginal bone level of dental implants that have functioned over 7-years. Materials and Methods: In 92 patients, 178 dental implants were included. Implant-related factors (diameter, length, prosthetic splint), patient-related factors (gender, smoking, plaque index, compliance to supportive periodontal therapy) and surgery-related factors (proficiency of surgeon, bone graft) were evaluated via clinical and radiographic examination. The marginal bone level was determined by intraoral standard radiography at the mesial and distal aspects of each implant using an image analysis software program. Results: The survival rate of all the implants was 94.94% and the marginal bone level was $0.89{\pm}1.05mm$, these results are consistent with other studies that present long-term good clinical results. Implant length and plaque index among several factors were statistically significant for implant survival rate (P < 0.05). Smoking and the presence of regeneration surgery were statistically significant for the marginal bone level (P < 0.05). Conclusion: Dental implant that have functioned over 7-years showed favorable long-term survival rates and marginal bone level. Implant length and plaque control should be considered for improving the long-term clinical results. It is needed that careful application of bone regeneration technique and smoking control for maintaining of marginal bone level.

키워드

참고문헌

  1. Brånemark 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. Brånemark R, Skalak R. An in-vivo method for biomechanical characterization of bone-anchored implants. Med Eng Phys 1998;20:216-9. https://doi.org/10.1016/S1350-4533(98)00023-X
  3. Flores-Guillen J, Álvarez-Novoa C, Barbieri G, Martín C, Sanz M. Five-year outcomes of a randomized clinical trial comparing bone level im- plants with either submerged or transmucosal healing. J Clin Periodontol 2018;45:125-35.
  4. Niedermaier R, Stelzle F, Riemann M, Bolz W, Schuh P, Wachtel H. Implant-supported immediately loaded fxed full-arch dentures: evaluation of implant survival rates in a case cohort of up to 7 years. Clin Implant Dent Relat Res 2017;19:4-19. https://doi.org/10.1111/cid.12421
  5. Hasegawa T, Kawabata S, Takeda D, Iwata E, Saito I, Arimoto S, Kimoto A, Akashi M, Suzuki H, Komori T. Survival of Brånemark System MK III implants and analysis of risk factors associated with implant failure. Int J Oral Maxillofac Surg 2017;46: 267-73.
  6. Roos J, Sennerby L, Lekholm U, Jemt T, Grondahl K, Albrektsson T. A qualitative and quantitative method for evaluating implant success: a 5-year ret- rospective analysis of the Branemark implant. Int J Oral Maxillofac Implants 1997;12:504-14.
  7. ten Bruggenkate CM, van der Kwast WA, Oosterbeek HS. Success criteria in oral implantology. A review of the literature. Int J Oral Implantol 1990;7: 45-51.
  8. 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
  9. van Steenberghe D, Lekholm U, Bolender C, Fol- mer T, Henry P, Herrmann I, Higuchi K, Laney W, Linden U, Astrand P. Applicability of osseointegrated oral implants in the rehabilitation of partial edentulism: a prospective multicenter study on 558 fxtures. Int J Oral Maxillofac Implants 1990;5:272- 81.
  10. Herrmann I, Lekholm U, Holm S, Kultje C. Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures. Int J Oral Maxillofac Implants 2005;20:220-30.
  11. Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res 2006;17:35-51. https://doi.org/10.1111/j.1600-0501.2006.01349.x
  12. Ivanoff CJ, Grondahl K, Sennerby L, Bergstrom C, Lekholm U. Infuence of variations in implant diameters: a 3-to 5-year retrospective clinical report. Int J Oral Maxillofac Implants 1999;14:173-80.
  13. Mendonça JA, Francischone CE, Senna PM, Matos de Oliveira AE, Sotto-Maior BS. A retrospective evaluation of the survival rates of splinted and non-splinted short dental implants in posterior partially edentulous jaws. J Periodontol 2014;85:787- 94. https://doi.org/10.1902/jop.2013.130193
  14. Moy PK, Medina D, Shetty V, Aghaloo TL. Int J Oral Maxillofac Implants 2005;20:569-77.
  15. Aglietta M, Siciliano VI, Rasperini G, Cafiero C, Lang NP, Salvi GE. A 10-year retrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokers. Clin Oral Implants Res 2011;22:47-53. https://doi.org/10.1111/j.1600-0501.2010.01977.x
  16. Higuchi KW, Folmer T, Kultje C. Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. J Oral Maxillofac Surg 1995;53:264-8. https://doi.org/10.1016/0278-2391(95)90222-8
  17. Melo MD, Shafie H, Obeid G. Implant survival rates for oral and maxillofacial surgery residents: a retrospective clinical review with analysis of resi- dent level of training on implant survival. J Oral Maxillofac Surg 2006;64:1185-9. https://doi.org/10.1016/j.joms.2006.04.014
  18. Simion M, Jovanovic SA, Tinti C, Benfenati SP. Long-term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation. A retrospective study on 123 implants with 1-5 year follow-up. Clin Oral Implants Res 2001;12: 35-45. https://doi.org/10.1034/j.1600-0501.2001.012001035.x
  19. Inglam S, Suebnukarn S, Tharanon W, Apatananon T, Sitthiseripratip K. Infuence of graft quality and marginal bone loss on implants placed in maxillary grafted sinus: a fnite element study. Med Biol Eng Comput 2010;48:681-9. https://doi.org/10.1007/s11517-010-0584-3
  20. Wennström J, Zurdo J, Karlsson S, Ekestubbe A, Gröndahl K, Lindhe J. Bone level change at implant-supported fxed partial dentures with and without cantilever extension after 5 years in function. J Clin Periodontol 2004;31:1077-83. https://doi.org/10.1111/j.1600-051X.2004.00603.x
  21. Mombelli A, van Oosten MA, Schurch E Jr, Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiolo Immunol 1987;2:145-51. https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
  22. Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 2012;23:2-21. https://doi.org/10.1111/j.1600-0501.2012.02547.x
  23. 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
  24. Herrmann I, Lekholm U, Holm S, Kultje C. Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures. Int J Oral Maxillofac Implants 2005;20:220-30.
  25. Romeo E, Lops D, Margutti E, Ghisolf M, Chi- apasco M, Vogel G. Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system. Int J Oral Maxillofac Implants 2004;19:247-59.
  26. Lemmerman KJ, Lemmerman NE. Osseointegrated dental implants in private practice: a long-term case series study. J Periodontol 2005;76:310-9. https://doi.org/10.1902/jop.2005.76.2.310
  27. Javed F, Romanos GE. Role of implant diameter on long-term survival of dental implants placed in posterior maxilla: a systematic review. Clin Oral Investig 2015;19:1-10. https://doi.org/10.1007/s00784-014-1333-z
  28. Serino G, Ström C. Peri-implantitis in partially edentulous patients: association with inadequate plaque control. Clin Oral Implants Res 2009;20: 169-74. https://doi.org/10.1111/j.1600-0501.2008.01627.x
  29. 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 Suppl 3:197-212. https://doi.org/10.1034/j.1600-051X.29.s3.12.x
  30. Lang NP, Tonetti MS. Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent 2003;1:7-16.
  31. Renvert S, Persson GR. Supportive periodontal therapy. Periodontol 2000 2004;36:179-95. https://doi.org/10.1111/j.1600-0757.2004.03680.x
  32. Matarasso S, Rasperini G, Iorio Siciliano V, Salvi GE, Lang NP, Aglietta M. A 10-year retrospective analysis of radiographic bone-level changes of implants supporting single-unit crowns in periodontally compromised vs. periodontally healthy patients. Clin Oral Implants Res 2010;21:898-903.
  33. 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
  34. Wahlström M, Sagulin GB, Jansson LE. Clinical follow-up of unilateral, fxed dental prosthesis on maxillary implants. Clin Oral Implants Res 2010;21: 1294-300. https://doi.org/10.1111/j.1600-0501.2010.01948.x
  35. Gianserra R, Cavalcanti R, Oreglia F, Manfredonia MF, Esposito M. Outcome of dental implants in patients with and without a history of periodontitis: a 5-year pragmatic multicentre retrospective cohort study of 1727 patients. Eur J Oral Implantol 2010; 3:307-14.
  36. Karoussis IK, Salvi GE, Heitz-Mayfeld LJ, Brägger U, Hämmerle 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;14:329-39. https://doi.org/10.1034/j.1600-0501.000.00934.x
  37. Quirynen M, Abarca M, Van Assche N, Nevins M, van Steenberghe D. Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis. J Clin Periodontol 2007;34:805-15. https://doi.org/10.1111/j.1600-051X.2007.01106.x
  38. Galindo-Moreno P, Fernandez-Jimenez A, Avila-Ortiz G, Silvestre FJ, Hernández-Cortes P, Wang HL. Marginal bone loss around implants placed in maxillary native bone or grafted sinuses: a retro-spective cohort study. Clin Oral Implants Res 2014; 25:378-84.
  39. Shibli JA, Piattelli A, Iezzi G, Cardoso LA, Onuma T, de Carvalho PS, Susana d, Ferrari DS, Mangano C, Zenobio EG. Effect of smoking on early bone healing around oxidized surfaces: a prospective, controlled study in human jaws. J Periodontol 2010; 81:575-83. https://doi.org/10.1902/jop.2010.090493
  40. Duan X, Wu T, Xu X, Chen D, Mo A, Lei Y, Cheng L, Man Y, Zhou X, Wang Y, Yuan Q. Smoking may lead to marginal bone loss around non-submerged implants during bone healing by altering salivary microbiome: a prospective study. J Periodontol 2017;88:1297-308. https://doi.org/10.1902/jop.2017.160808
  41. Nevins M, Mellonig JT, Clem DS 3rd, Reiser GM, Buser DA. Implants in regenerated bone: long-term survival. Int J Periodontics Restorative Dent 1998;18:34-45.
  42. Palmer RM, Smith BJ, Palmer PJ, Floyd PD, Johannson CB, Albrektsson T. Effect of loading on bone regenerated at implant dehiscence sites in hu- mans. Clin Oral Implants Res 1998;9:283-91. https://doi.org/10.1034/j.1600-0501.1998.090501.x