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The risk factors for implant survival and marginal bone loss: a retrospective long-term study

임플란트 장기간 유지와 변연골 소실에 영향을 주는 요인들에 대한 후향적 연구

  • Lee, Eun-Woo (Department of Periodontology, Dental Research Institute, School of Dentistry, Chonnam National University) ;
  • Jung, Ha-Na (Department of Dentistry, Chonnam National University Hwasun Hospital) ;
  • Jo, Yujin (Department of Prosthodontics, School of Dentistry, Chonnam National University) ;
  • Kim, Ok-Su (Department of Periodontology, Dental Research Institute, School of Dentistry, Chonnam National University)
  • 이은우 (전남대학교 치의학전문대학원 치주과학교실, 치의학연구소) ;
  • 정하나 (화순전남대학교병원 치과) ;
  • 조유진 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 김옥수 (전남대학교 치의학전문대학원 치주과학교실, 치의학연구소)
  • Received : 2022.06.03
  • Accepted : 2022.06.10
  • Published : 2022.06.30

Abstract

Purpose: This study aims to investigate the risk indicators contributing to implant failure, and analyze the relationship between risk indicators and marginal bone loss (MBL) through long-term follow-up over 3 years. Materials and Methods: From 2003 to 2017, patients' medical charts with a history of dental implant surgery at Chonnam National University Dental Hospital were reviewed retrospectively. The patient's demographic variables, and clinical variables were recorded. Periapical radiographs were used to evaluated the changes in MBL around implants. And we analyzed implant survival rates. Multiple regression analysis with backward elimination was conducted to correlate the patient's clinical variables and implant failure and Pearson correlation analysis was performed to the correlated between implant long-term survival rates and MBL and initial stability. Results: In multiple regression analysis, there was a statistically significant negative correlation between abutment connection type (β = -.189, P < .05), with or without SPT (β = -.163, P < .05), diabetes (β = -.164, P < .05), osteoporosis (β = -.211, P < .05) and MBL. Anticoagulant medication influenced the long-term success rate of implants. PTV values at the second implant surgery showed a statistically significant negative correlation with long-term implant survival (P < .05). Conclusion: For the long-term success of the implant, the appropriate abutment connection type must be selected and the periodic SPT is recommended. Systemic diseases such as diabetes and osteoporosis and anticoagulant medication should be considered. Furthermore, since high PTV at the second implant surgery correlated with the long-term survival rates of the implant, initial stability should be carefully considered before undergoing the prosthetic procedure.

목적: 3년 이상 기능한 임플란트의 장기 추적을 통해 임플란트 실패에 기여하는 위험지표를 조사하고 변연골소실(MBL)간의 상관관계를 분석하는 것이다. 연구 재료 및 방법: 2003년부터 2017년까지 전남대학교 치과병원에서 임플란트 수술 기왕력이 있는 환자의 진료기록부를 토대로 후향적 조사 시행하였다. 환자의 인구통계학적 변수 및 임상적 변수와 임플란트 주위 변연골소실 평가를 위한 치근단 방사선 사진을 사용하여 임플란트 생존율을 분석하였다. 환자의 임상변수와 임플란트 실패의 상관관계를 규명하기 위해 후진소거법을 이용한 다중회귀분석 시행하였고, 임플란트 장기생존율과 MBL 및 초기 안정성 간의 상관관계를 규명하기위해 Pearson 상관분석 시행하였다. 결과: 다중회귀분석 결과 지대주 연결 유형(β = -.189, P < .05), SPT 유무(β = -.163, P < .05), 당뇨(β = -.164, P < .05), 골수염(β = -.211, P < .05)이 MBL과 음의 상관관계가 있었다. 임플란트 장기 성공률에 항응고제, 임플란트 2차수술 시 PTV값이 영향을 미쳤다. 결론: 임플란트 장기 성공을 위해서는 적절한 지대주 연결 유형을 선택해야 하며, 주기적 SPT가 필요하다. 당뇨병, 골다공증 같은 전신 질환과 항응고제 사용 질환을 고려해야한다. 또한 임플란트 2차 수술시 높은 PTV가 임플란트 장기 생존율과 상관관계가 있기 때문에 보철 수복 전 초기 안정성을 신중히 고려해야한다.

Keywords

References

  1. Branemark PI, Svensson B, van Steenberghe D. Ten-year survival rates of fixed prostheses on four or six implants ad modum Branemark in full edentulism. Clin Oral Implants Res 1995;6:227-31. https://doi.org/10.1034/j.1600-0501.1995.060405.x
  2. Mengel R, Schroder T, Flores-de-Jacoby L. Osseointegrated implants in patients treated for generalized chronic periodontitis and generalized aggressive periodontitis: 3- and 5-year results of a prospective long-term study. J Periodontol 2001;72:977-89. https://doi.org/10.1902/jop.2001.72.8.977
  3. Buser D, Ingimarsson S, Dula K, Lussi A, Hirt HP, Belser UC. Long-term stability of osseointegrated implants in augmented bone: a 5-year prospective study in partially edentulous patients. Int J Periodontics Restorative Dent 2002;22:109-17.
  4. Bragger U, Hirt-Steiner S, Schnell N, Schmidlin K, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Lang NP. Complication and failure rates of fixed dental prostheses in patients treated for periodontal disease. Clin Oral Implants Res 2011;22:70-7. https://doi.org/10.1111/j.1600-0501.2010.02095.x
  5. 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
  6. Lang NP, Zitzmann NU. Clinical research in implant dentistry: evaluation of implant-supported restorations, aesthetic and patient-reported outcomes. J Clin Periodontol 2012;39:133-8. https://doi.org/10.1111/j.1600-051X.2011.01842.x
  7. Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Implants Res 2012;23 Suppl 6:22-38.
  8. Chiapasco M. Early and immediate restoration and loading of implants in completely edentulous patients. Int J Oral Maillofac Implants 2004;19:76-91.
  9. Cochran DL, Nevins M. Biologic width: a physiologically and politically resilient structure. Int J Periodontics Restorative Dent 2012;32:371-3.
  10. Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failure rates and associated risk factors. Int J Oral Maxillofac Implants 2005;20:569-77.
  11. Ahmed A, Chambers MS, Goldschmidt MC, Habib A, Lei X, Jacob RF. Association between microbial flora and tissue abnormality around dental implants penetrating the skin in reconstructed oral cancer patients. Int J Oral Maillofac Implants 2012;27:684-94.
  12. Kasat V, Ladda R. Smoking and dental implants. J Int Soc Prev Community Dent 2012;2:38-41. https://doi.org/10.4103/2231-0762.109358
  13. Adell R, Lekholm U, Rockler B, 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
  14. Sennerby L, Merdith N. Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications. Periodontol 2000 2008;47:51-66. https://doi.org/10.1111/j.1600-0757.2008.00267.x
  15. Rosenberg ES, Cho SC, Elian N, Jalbout ZN, Froum S, Evian CI. A comparison of characteristics of Implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report. Int J Oral Maillofac Implants 2004;19:873-9.
  16. 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
  17. Penarrocha M, Palomar M, Sanchis JM, Guarinos J, Balaguer J. Radiologic study of marginal bone loss around 108 dental implants and its relationship to smoking, implant location, and morphology. Int J Oral Maxillofac Implants 2004;19:861-7.
  18. de Medeiros RA, Pellizzer EP, Vechiato Filho AJ, Dos Santos DM, da Silva EV, Goiato MC. Evaluation of marginal bone loss of dental implants with internal or external connections and its association with other variables: A systematic review. J Prosthet Dent 2016;116:501-6. https://doi.org/10.1016/j.prosdent.2016.03.027
  19. Lemos CAA, Verri FR, Bonfante EA, Santiago Junior JF, Pellizzer EP. Comparison of external and internal implant-abutment connections for implant supported prosthesis. A systematic review and meta-analysis. J Dent 2018;70:14-22. https://doi.org/10.1016/j.jdent.2017.12.001
  20. Caricasulo R, Malchiodi L, Ghensi P, Fantozzi G, Cucchi A. The influence of implant-abutment connection to peri-implant bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2018;20:653-64. https://doi.org/10.1111/cid.12620
  21. Knowles JW, Burgett FG, Nissle RR, Shick RA, Morrison EC, Ramfjord SP. Results of periodontal treatment related to pocket depth and attachment level. Eight years. J Periodontol 1979;50:225-33. https://doi.org/10.1902/jop.1979.50.5.225
  22. Ramfjord SP, Caffesse RG, Morrison EC, Hill RW, Kerry GJ, Appleberry EA, Nissle RR, Stults DL. Four modalities of periodontal treatment compared over 5 years. J Periodontal Res 1987;22:222-3. https://doi.org/10.1111/j.1600-0765.1987.tb01573.x
  23. Ramfjord SP, Morrison EC, Burgett FG, Nissle RR, Shick RA, Zann GJ, Knowles JW. Oral hygiene and maintenance of periodontal support. J Periodontol 1982;53:26-30. https://doi.org/10.1902/jop.1982.53.1.26
  24. Lindhe J, Nyman S. Long-term maintenance of patients treated for advanced periodontal disease. J Clin Periodontol 1984;11:504-14. https://doi.org/10.1111/j.1600-051X.1984.tb00902.x
  25. Choi SJ, Jeong HN, Kim OS. Effect of supportive periodontal therapy on long-term implant survival rate. Oral Biol Res 2018;42:228-34. https://doi.org/10.21851/obr.42.04.201812.228
  26. Balshi SF, Wolfinger GJ, Balshi TJ. An examination of immediately loaded dental implant stability in the diabetic patient using resonance frequency analysis (RFA). Quintessence Int 2007;38:271-9.
  27. Fiorellini JP, Chen PK, Nevins M, Nevins ML. A retrospective study of dental implants in diabetic patients. Int J Periodontics Restorative Dent 2000;20:366-73.
  28. Kapur KK, Garrett NR, Hamada MO, Roumanas ED, Freymiller E, Han T, Diener RM, Levin S, Ida R. A randomized clinical trial comparing the efficacy of mandibular implant-supported overdentures and conventional dentures in diabetic patients. Part I: Methodology and clinical outcomes. J Prosthet Dent 1998;79:555-69. https://doi.org/10.1016/S0022-3913(98)70177-5
  29. Baxter JC, Fattore L. Osteoporosis and osseointegration of implants. J Prosthodont 1993;2:120-5. https://doi.org/10.1111/j.1532-849x.1993.tb00393.x
  30. Dao TT, Anderson JD, Zarb GA. Is osteoporosis a risk factor for osseointegration of dental implants? Int J Oral Maxillofac Implants 1993;8:137-44.
  31. Blomqvist JE, Alberius P, Isaksson S, Linde A, Hansson BG. Factors in implant integration failure after bone grafting: an osteometric and endocrinologic matched analysis. Int J Oral Maxillofac Surg 1996;25:63-8. https://doi.org/10.1016/S0901-5027(96)80015-4
  32. Truhlar RS, Morris HF, Ochi S, Winkler S. Assessment of implant mobility at second-stage surgery with the Periotest: DICRG Interim Report No. 3. Dental Implant Clinical Research Group. Implant Dent 1994;3:153-6. https://doi.org/10.1097/00008505-199409000-00002
  33. Friberg B, Sennerby L, Meredith N, Lekholm U. A comparison between cutting torque and resonance frequency measurements of maxillary impalnts. A 20-month clinical study. Int J Oral Maxillofac Surg 1999;28:297-303. https://doi.org/10.1016/S0901-5027(99)80163-5
  34. Vidyasagar L, Salms G, Apse P, Teibe U. Dental implant stability at stage I and II surgery as measured using resonance frequency analysis. Stomatologija 2004;6:67-72.