口腔肿瘤治疗后上颌种植义齿失败的分析

Influencing factors of maxillary implant-supported prostheses after oral neoplasms treatment

目的:分析口腔肿瘤治疗和重建术后患者上颌种植修复失败的影响因素。方法:27例病人,共植入131枚上颌种植体,25例患者佩戴了上颌种植义齿,12例接受了术前或术后的放射治疗,采用Kaplan-meier的方法评价种植体和修复体的生存率,Log-rank检验比较放疗和未放疗患者的种植体和修复体生存率,对所观察种植体的边缘骨吸收,种植体周围袋深度,菌斑指数,种植体周围出血指数以及吸烟与否等资料进行了统计学分析。结果:接受放疗和未接受放疗的患者之间,其种植体和修复体的5年累计生存率差异均有显著性(P<0.01);种植体周围袋深度,菌斑指数,种植体周围出血指数以及吸烟与种植义齿失败之间无显著差异。结论:放疗是影响上颌种植修复失败的主要因素,其它因素尚需进一步探索。

Objective: To identify the influencing factors of implants failure in the maxillary rehabilitation with implant-supported prostheses after mouth neoplasms treatment and/or reconstructive surgery. Methods: 27 patients received atotal of 131 implants in maxilla. 25 patients received maxillary implant-supported prostheses. 12 were treated with additionalpresurgical or postsurgical radiotherapy. The cumulative survival rates of implants and prostheses were evaluated by theproduct-limit-estimates method according to Kaplan-Meier. The compare of cumulative survival rate on irradiated andnon-irradiated patients was statistically evaluated by Log-rank test. Marginal bone resorption, peri-implant pocket probingdepth, peri-implant bleeding index, plaque index and tobacco usage were statistically analyzed. Results: There was asignificant difference of cumulative implants and prostheses survival rates between non-irradiated and irradiated maxillarybone (P<0.01). There was no significant relationship between implants failure and Marginal bone resorption, peri-implantpocket probing depth, peri-implant bleeding index, plaque index and tobacco usage. Conclusion: Radiotherapy is themain influencing factor of implants failure. The further research is necessary to identify other influencing factors.