上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (3): 292-297.doi: 10.19439/j.sjos.2023.03.014

• 论著 • 上一篇    下一篇

影响种植体生存时间的相关因素分析

杨治洁1, 唐庭1, 刘堃1, 张磊1, 翟沁凯2   

  1. 1.合肥市口腔医院,安徽医科大学合肥口腔临床学院 口腔种植科,2.口腔颌面外科,安徽 合肥 230001
  • 收稿日期:2022-05-17 修回日期:2022-08-23 出版日期:2023-06-25 发布日期:2023-06-28
  • 通讯作者: 翟沁凯,E-mail: zhaiqinkai@163.com
  • 作者简介:杨治洁（1974-）,女,学士,副主任医师,E-mail: hfyangzhijie@sina.com
  • 基金资助:
    合肥市卫健委应用医学研究项目（Hwk2020yb0018）

Research for the influencing factors affecting the long-term survival time of implants: a retrospective cohort study

YANG Zhi-jie1, TANG Ting1, LIU Kun1, ZHANG Lei1, ZHAI Qin-kai2   

  1. 1. Department of Oral Implantology, 2. Department of Oral and Maxillofacial Surgery, Hefei Stomatology Hospital & Hefei Clinical School of Stomatology, Anhui Medical University. Hefei 230001, Anhui Province, China
  • Received:2022-05-17 Revised:2022-08-23 Online:2023-06-25 Published:2023-06-28

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摘要： 目的：探讨种植体失败事件与时间和牙位的相关性及影响种植体生存时间的相关因素。方法：采用回顾性队列研究,分析2019年1月—2021年12月在合肥市口腔医院口腔种植科因种植失败复诊拆除种植体的患者。预测变量为手术年龄、性别、吸烟、口腔卫生情况、血糖、颌位、牙位、种植体类型、种植体数量、手术医师、植入时机、负载时机、抗生素使用时机,结果变量为种植体生存时间和种植体失败事件。采用SPSS 21.0软件包对数据进行χ2检验、Kaplan-Meier (Long Rank 检验）及Cox比例风险模型分析。结果：89例患者纳入研究,拆除失败种植体95颗。失败种植体平均生存时间为31个月(95%CI: 24.2~39.1)。种植体植入数量（P=0.038）、种植体负载时机（P=0.050）、牙位（P=0.024）与种植体生存时间显著相关。2颗种植体失败的风险是1颗种植体的3.709倍（95%CI: 1.075~12.795）,种植体晚期负载失败的风险是早期负载的1.551倍（95%CI: 0.999~2.406）。前牙种植失败的风险是磨牙的2.384倍（95%CI: 1.327~4.283）。约50%的患者在术后1年内拆除失败的种植体,随后的2~10年,拆除失败种植体的速率变得较为平缓。磨牙种植体周围炎最为常见（50%）,种植体折断一般在术后55个月发生(95%CI:42.2~67.9),发生时间最晚（P=0.000）。结论：种植体植入数量、负载时机和牙位是种植体生存时间的影响因素。种植术后第1年的随访尤为重要,便于及时发现问题,及时干预。种植体失败事件的发生与牙位和时间相关。

关键词: 种植体, 多因素分析, 生存时间, 种植体周围炎

Abstract: PURPOSE: To investigate the timing of implant failure events and their relationship with the dental position and the factors affecting the survival time of implants. METHODS: A retrospective cohort study was conducted to analyze the patients who had implants removed due to implant failure in the Department of Dental Implantology of Hefei Stomatological Hospital from January 2019 to December 2021. The predictor variables were surgical age, gender, smoking habit, oral hygiene, glucose value, jaw and dental position, implant type, implant number, surgeon, implant placement timing, implant loading timing, and antibiotic use timing. The outcome measurement was the implant survival time and implant failure events. Chi-square test, Kaplan-Meier(Log-rank test), and Cox proportional hazards model were used to identify and stepwise determined potential risk factors for implant survival time with SPSS 21.0 software package. RESULTS: A total of 89 patients(95 implants) had to remove implants. The mean survival time of the failed implants was 31(95%CI :24.2-39.1) months. Implant number (P=0.038), implant loading timing (P=0.050), and tooth position (P=0.024) were significantly correlated with the implant survival time. The risk of failure with 2 implants was 2.709 (HR=3.709, 95%CI: 1.075-12.795) times higher than that with 1 implant, and the risk of failure with late implant loading was 0.551(HR=1.511, 95%CI: 0.999-2.406) times higher than that with early implant loading. The risk of anterior teeth implant failure was 1.384 times higher than that of molars(HR=2.384, 95%CI:1.327-4.283). For patients with implant failure, about 50% of the patients removed the failed implant within 1 year after surgery, and the rate of removal of the failed implant gradually slowed down in the following 2-10 years. Peri-implantitis most commonly occurred in molars(50%). Implant fracture lastly occurred at 55(95%CI: 42.2-67.9) months postoperatively（P=0.000）. CONCLUSIONS: The number of implants, implant loading timing, and dental position were considered as the influencing factors for the survival time of implants. Follow-up in the first year after implantation seems to be particularly important for timely detection of problems and timely intervention. The occurrence of implant failure events was related to dental position and time.

Key words: Implant, Multivariate analysis, Survival time, Peri-implantitis

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