Impact of Different Surgeons on Dental Implant Failure
Impact of Different Surgeons on Dental Implant Failure
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DOI：
10.11607/ijp.5151
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发表时间：
2017-09-01
影响因子：
2.3
通讯作者：
Wennerberg, Ann
中科院分区：
文献类型：
--
作者：
Chrcanovic, Bruno Ramos;Kisch, Jeno;Wennerberg, Ann
目的：评估几个因素对牙种植体失败患病率的影响，特别考虑不同牙科医生的种植体放置。材料和方法：这项回顾性研究基于在一家专科诊所接受10，096个种植体的2，670名患者。仅纳入了在诊所植入至少200个种植体的外科医生治疗的患者和种植体的数据。Kaplan-Meier曲线根据个体外科医生进行分层。使用广义估计方程（GEE）方法来解释重复观察（几个植入物）放置在单个患者中的事实。采用描述性统计量分别对每位外科医生的骨量、骨质、种植体位置、种植体表面和种植体系统等因素进行分析。结果：共有10名外科医生合格。每个个体的生存曲线之间的差异具有统计学意义。多变量GEE模型显示以下变量具有统计学显著性：外科医生、磨牙症、抗抑郁药摄入量、位置、种植体长度和种植体系统。失败绝对数量最高的外科医生也是在骨质差的部位插入最多种植体的外科医生，并且在大多数情况下使用旋转种植体，而失败绝对数量最低的外科医生主要使用现代种植体。根据不同外科医生对车削和现代种植体进行的单独生存分析显示，累积生存率存在统计学显著差异。结论：不同外科医生之间的失败发生率不同，偶尔达到显著水平。尽管无法确定直接的因果关系，但本研究的结果表明，外科医生的技术、技能和/或判断可能对种植体存活率产生负面影响。
Purpose: To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. Materials and Methods: This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. Results: A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Conclusion: Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.