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구치부 임플란트 지지 고정성 보철물의 재료에 따른 생존율, 성공률 및 합병증에 대한 후향적 연구

Retrospective study on survival, success rate and complication of implant-supported fixed prosthesis according to the materials in the posterior area

  • 채현석 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 왕원곤 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 이정진 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 송광엽 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소) ;
  • 서재민 (전북대학교 치의학전문대학원 치과보철학교실 및 구강생체과학연구소)
  • Chae, Hyun-Seok (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Wang, Yuan-Kun (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Lee, Jung-Jin (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Song, Kwang-Yeob (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University) ;
  • Seo, Jae-Min (Department of Prosthodontics, School of Dentistry and Institute of Oral Bio-Science, Chonbuk National University)
  • 투고 : 2019.06.13
  • 심사 : 2019.08.29
  • 발행 : 2019.10.31

초록

목적: 이 연구의 목적은 구치부 영역에서 임플란트 지지 고정 보철물의 재료에 따른 생존율과 성공률을 후향적으로 조사하는 것이다. 또한 임플란트 지지 고정성 보철물에서 발생하는 합병증의 양상을 관찰하고 실패에 영향을 주는 요인을 평가하는 것이다. 대상 및 방법: 2011년 1월부터 2018년 6월 사이에 전북대학교 치과병원 치과보철과에서 한 명의 보철전문의에 의해 구치부 임플란트 보철 수복을 시행한 환자를 대상으로 하였다. 의료기록을 통해 환자의 성별, 연령, 보철물의 재료, 위치, 유형 및 합병증을 조사하였다. 생존율 및 성공률 분석을 위해 Kaplan-Meier 분석법을 이용하였으며, 집단간 비교를 위해 Log-rank test를 사용하였다. 또한 Cox proportional hazards model을 이용하여 위험요소가 성공률에 미치는 영향을 분석하였다. 결과: 총 245명의 환자에서 364개의 임플란트 보철물이 관찰되었으며, 평균 추적관찰기간은 17.1개월이었다. 전체 임플란트 보철물의 3년, 5년 누적생존율은 각각 97.5%, 91.0%로 관찰되었으며, 총 5개의 임플란트 보철물이 실패하여 제거되었다. 임플란트 보철물의 3년, 5년 누적성공률은 각각 61.1%, 32.9%로 관찰되었으며, 재료, 성별, 연령, 보철물의 위치, 유형은 누적성공률에 영향을 미치지 않았다 (P > .05). 합병증은 인접면 접촉 상실 (53건), 유지력 상실 (17건), 임플란트 주위 점막염 (12건), 저위교합 (4건) 등의 순으로 발생하였다. 결론: 구치부에서 임플란트 지지 고정성 보철물의 높은 누적생존율을 고려할 때, 임플란트는 수복 재료와 상관없이 구치부에서 치아를 대체할 수 있는 신뢰할만한 치료방법으로 생각된다. 그러나 합병증이 빈번히 발생하기 때문에 정기적인 검사와 필요한 경우 수리 및 조정이 매우 중요하다.

Purpose: The purpose of this study was to retrospectively investigate the survival and success rate of implant-supported fixed prosthesis according to the materials in the posterior area. Other purposes were to observe the complications and evaluate the factors affecting failure. Materials and methods: Patients who had been restored implant prosthesis in the posterior area by the same prosthodontist in the department of prosthodontics, dental hospital, Chonbuk National University, in the period from January 2011 to June 2018 were selected for the study. The patient's sex, age, material, location, type of prosthesis and complications were examined using medical records. The KaplanMeier method was used to analyze the survival and success rate. The Log-rank test was conducted to compare the differences between the groups. Cox proportional hazards model was used to assess the association between potential risk factors and success rate. Results: A total of 364 implants were observed in 245 patients, with an average follow-up of 17.1 months. A total of 5 implant prostheses failed and were removed, and the 3 and 5 year cumulative survival rate of all implant prostheses were 97.5 and 91.0, respectively. The 3 and 5 year cumulative success rate of all implant prostheses were 61.1% and 32.9%, respectively. Material, sex, age, location and type of prosthesis did not affect success rate (P>.05). Complications occurred in the order of proximal contact loss (53 cases), retention loss (17 cases), peri-implant mucositis (12 cases), infraocclusion (4 cases) and so on. Conclusion: Considering a high cumulative survival rate of implant-supported fixed prostheses, regardless of the materials, implant restored in posterior area can be considered as a reliable treatment to tooth replacement. However, regular inspections and, if necessary, repairs and adjustments are very important because of the frequent occurrence of complications.

키워드

참고문헌

  1. Fehmer V, Muhlemann S, Hammerle CH, Sailer I. Criteria for the selection of restoration materials. Quintessence Int 2014;45:723-30.
  2. Benic GI, Muhlemann S, Fehmer V, Hammerle CH, Sailer I. Randomized controlled within-subject evaluation of digital and conventional workflows for the fabrication of lithium disilicate single crowns. Part I: digital versus conventional unilateral impressions. J Prosthet Dent 2016;116:777-82. https://doi.org/10.1016/j.prosdent.2016.05.007
  3. Guess PC, Att W, Strub JR. Zirconia in fixed implant prosthodontics. Clin Implant Dent Relat Res 2012;14:633-45. https://doi.org/10.1111/j.1708-8208.2010.00317.x
  4. Silva NR, Bonfante EA, Zavanelli RA, Thompson VP, Ferencz JL, Coelho PG. Reliability of metalloceramic and zirconia-based ceramic crowns. J Dent Res 2010;89:1051-6. https://doi.org/10.1177/0022034510375826
  5. Walton TR. An up-to-15-year comparison of the survival and complication burden of three-unit tooth-supported fixed dental prostheses and implant-supported single crowns. Int J Oral Maxillofac Implants 2015;30:851-61. https://doi.org/10.11607/jomi.4220
  6. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90:121-32. https://doi.org/10.1016/S0022-3913(03)00212-9
  7. Gothberg C, Bergendal T, Magnusson T. Complications after treatment with implant-supported fixed prostheses: a retrospective study. Int J Prosthodont 2003;16:201-7.
  8. Byun SJ, Heo SM, Ahn SG, Chang M. Analysis of proximal contact loss between implant-supported fixed dental prostheses and adjacent teeth in relation to influential factors and effects. A cross-sectional study. Clin Oral Implants Res 2015;26:709-14. https://doi.org/10.1111/clr.12373
  9. Yoon JH, Park YB, Youn SH, Oh NS. Korea Academy of Prosthodontics criteria for longevity studies of dental prostheses. J Korean Acad Prosthodont 2016;54:341-53. https://doi.org/10.4047/jkap.2016.54.4.341
  10. Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res 2018;29:199-214.
  11. Buser D, Weber HP, Lang NP. Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants. Clin Oral Implants Res 1990;1:33-40. https://doi.org/10.1034/j.1600-0501.1990.010105.x
  12. 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;13:144-53. https://doi.org/10.1034/j.1600-0501.2002.130204.x
  13. 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;15:625-42. https://doi.org/10.1111/j.1600-0501.2004.01117.x
  14. Koori H, Morimoto K, Tsukiyama Y, Koyano K. Statistical analysis of the diachronic loss of interproximal contact between fixed implant prostheses and adjacent teeth. Int J Prosthodont 2010;23:535-40.
  15. Chopra A, Sivaraman K, Narayan AI, Balakrishnan D. Etiology and classification of food impaction around implants and implant-retained prosthesis. Clin Implant Dent Relat Res 2019;21:391-7. https://doi.org/10.1111/cid.12716
  16. Michalakis KX, Pissiotis AL, Hirayama H. Cement failure loads of 4 provisional luting agents used for the cementation of implant-supported fixed partial dentures. Int J Oral Maxillofac Implants 2000;15:545-9.
  17. In J, Lee DK. Survival analysis: Part I - analysis of time-toevent. Korean J Anesthesiol 2018;71:182-91. https://doi.org/10.4097/kja.d.18.00067
  18. Lin RS, Leon LF. Estimation of treatment effects in weighted log-rank tests. Contemp Clin Trials Commun 2017;8:147-55. https://doi.org/10.1016/j.conctc.2017.09.004
  19. Sailer I, Strasding M, Valente NA, Zwahlen M, Liu S, Pjetursson BE. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic multiple-unit fixed dental prostheses. Clin Oral Implants Res 2018;29:184-98.
  20. Schneider D, Witt L, Hammerle CHF. Influence of the crownto-implant length ratio on the clinical performance of implants supporting single crown restorations: a cross-sectional retrospective 5-year investigation. Clin Oral Implants Res 2012;23:169-74. https://doi.org/10.1111/j.1600-0501.2011.02230.x
  21. Kolgeci L, Mericske E, Worni A, Walker P, Katsoulis J, Mericske-Stern R. Technical complications and failures of zirconia-based prostheses supported by implants followed up to 7 years: a case series. Int J Prosthodont 2014;27:544-52. https://doi.org/10.11607/ijp.3807