Factors Associated with Failure of Surface-Modified Implants up to Four Years of Function
Factors Associated with Failure of Surface-Modified Implants up to Four Years of Function
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DOI：
10.1111/j.1708-8208.2010.00282.x
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发表时间：
2012-06-01
影响因子：
3.6
通讯作者：
De Bruyn, Hugo
中科院分区：
文献类型：
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作者：
Cosyn, Jan;Vandenbulcke, Edward;De Bruyn, Hugo
目的：创新治疗理念对表面改性种植体失效的相对影响尚不清楚。这项回顾性研究旨在探讨这一点，使用的数据在大学研究生培训中心。材料和方法：纳入了3年内因各种适应症接受植入物治疗的患者。所有植入物的功能均至少1年。根据种植体长度/直径/位置、从牙齿缺失到种植体放置的时间、骨状况（原生/移植）、手术方案（两阶段/一阶段）、加载方案（延迟/早期/立即）、修复体类型（可拆卸/固定）、外科医生的经验水平（住院医生/实习医生）和专业（牙周病医生/口腔外科医生），对种植体失败的临床记录进行评价。使用Fisher精确检验检验每个协变量对失效的影响。构建Kaplan-Meier生存函数，并使用Mantel-Cox对数秩检验比较生存函数。为了校正可能的相互作用，采用了考克斯比例风险回归。结果：34/461（7.4%）例患者（245？，216？平均年龄51岁，范围1890）。基于单变量分析，显示对失效有显著影响的因素为植入位置（p =.015）、手术方案（p =.002）、加载方案（p =.002）、外科医生的经验水平（p =.035）和专业（p =.001）。当控制其他协变量时，只有加载方案具有显著影响（p =.049），与延迟加载相比，早期加载更容易失败（p =.014）。即刻加载和延迟加载显示出相当的种植体存活率（p = 0.311）。结论：在培训中心，缺乏经验的临床医生会受到严格的监控和亲自指导，种植治疗可能会非常成功。种植体特定变量不影响种植体存活，但早期负荷是种植体失效的风险指标，而立即负荷则不是。
Objectives: The relative impact of innovative treatment concepts on the failure of surface-modified implants is not well understood. This retrospective study aimed to explore this using data obtained in a university postgraduate training center. Material and Methods: Patients treated with implants for a variety of indications over a 3-year period were included. All implants had been at least 1 year in function. Clinical records were evaluated for implant failure and in reference to implant length/diameter/location, time from tooth loss to implant placement, bone condition (native/grafted), surgical protocol (two-/one-stage), loading protocol (delayed/early/immediate), type of prosthesis (removable/fixed), surgeon's experience level (resident/trainee) and specialty (periodontist/oral surgeon). The impact of each covariate on failure was tested using the Fisher's exact test. Kaplan-Meier survival functions were constructed and Mantel-Cox logrank tests were used to compare survival functions. To correct for possible interaction, Cox proportional Hazards regression was adopted. Results: Forty-one of 1,180 (3.5%) implants were lost in 34/461 (7.4%) patients (245 ?, 216 ?; mean age 51, range 1890). Factors showing significant impact on failure on the basis of univariate analyses were implant location (p = .015), surgical protocol (p = .002), loading protocol (p = .002), surgeon's experience level (p = .035) and specialty (p = .001). When controlling for other covariates, only the loading protocol had a significant influence (p = .049) with early loading more prone to failure (p = .014) when compared with delayed loading. Immediate loading and delayed loading showed comparable implant survival (p = .311). Conclusions: Implant therapy may be highly successful in a training center where inexperienced clinicians are strictly monitored and personally guided. Implant specific variables do not affect implant survival but early loading is a risk indicator for implant failure, whereas immediate loading is not.