Failed dental implants Diagnosis, removal and survival of reimplantations
Failed dental implants Diagnosis, removal and survival of reimplantations
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DOI：
10.14219/jada.2014.28
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发表时间：
2014-08-01
影响因子：
3.9
通讯作者：
Cavallaro, John
中科院分区：
文献类型：
--
作者：
Greenstein, Gary;Cavallaro, John
背景随着时间的推移，由于生物和技术问题，牙科植入物失败的百分比增加。不可避免地，临床医生将投入更多的时间来处理生病和失败的牙科种植体。作者检索了文献中关于失败种植体的诊断表现、死亡原因以及牙种植体修复的存活率的文章。作者发现，在缺乏表明种植体失败的活动度的情况下，关于骨丢失量没有精确的临界点（除了100%）。治疗或取出有问题的植入物的决定由治疗临床医生做出。文献中发现，第一次和第二次再植入后的生存率分别为71%至100%和50%至100%。100%的结果是基于小的种植体组，并且很少有数据说明第二次修复后的种植体存活率。移除种植体的决定需要基于临床评估、影像学评估或两者。如果植入物被认为是无望的，有设备可以帮助他们移除。此外，revertations可以成功地进行，但他们的生存率似乎低于种植体放置在网站，他们没有失去previous.Practical影响。患病的牙科种植体不应该过早地被谴责，因为患者通常对种植体周围炎的治疗有反应。许多患者希望在种植体失效的部位进行修复。这种方法是有价值的，特别是如果它使种植体支持的固定或可移动假体的制造成为可能。
Background. Over time, the percentage of dental implants that fail increases because of biological and technical issues. Inevitably, clinicians will dedicate more time to dealing with ailing and failing dental implants.Methods. The authors searched the literature for articles that addressed diagnostic manifestations of failed implants and reasons for their demise, as well as survival rates of dental implant reimplantations.Results. The authors found that there is no precise cut point (besides 100 percent) with regard to the amount of bone loss in the absence of mobility that indicates an implant has failed. The decision to treat or explant an ailing implant is a judgment call by the treating clinician. Survival rates found in the literature after first and second reimplantations ranged from 71 percent to 100 percent and 50 percent to 100 percent, respectively. The 100 percent findings were based on small groups of implants, and there were scant data addressing implant survival after second reimplantations.Conclusions. The decision to remove an implant needs to be based on clinical assessments, radiographic evaluations or both. If the implant is deemed hopeless, there are devices that facilitate their removal. Furthermore, reimplantations can be performed successfully, but their survival rate appears to be lower than that of implants placed at sites from which they were not lost formerly.Practical Implications. Ailing dental implants should not be condemned prematurely, because patients often respond to treatment of peri-implantitis. Many patients desire reimplantations in sites in which implants have failed. This procedure is valuable, especially if it makes possible the fabrication of an implant-supported fixed or removable prosthesis.