种植失败原因探析及再种植处理的体会

Analysis of failed dental implants and treatment for replacement

目的分析种植义齿失败原因,探讨再种植手术技巧。方法 1998年1月—2010年1月623例种植修复病例中,失败病例31例,共计52枚种植体。从脱落时间、部位和术中、术后并发症等方面分析失败原因;并对失败病例进行再种植及疗效评估。结果 52例脱落种植体,85%(44枚)发生于上部结构修复前,上颌第一磨牙种植体脱落率远高于其他牙位;上颌窦穿通和牙槽骨壁侧穿是种植手术失败的主要并发症。失败病例的再种植时间为3～6个月,2枚种植体脱落后进行第3次种植手术并仍获得临床成功。结论骨整合作用是种植义齿存活的关键因素,它受全身和局部因素的影响,前者主要为骨质疏松所致的骨密度降低,后者包括局部病变(牙周病)和局部解剖条件限制,即上颌窦和下牙槽神经所致的骨量不足,种植失败后再种植仍能取得首次种植同样的疗效。

Objective To analyse the causes of implants loss and to discuss the surgical techniques in second implantation,in order to raise the success rate of implanting prosthesis.Methods 623 implant cases were collected From 1998.1 to 2010.1.Among them,52 dental implants（31 cases） were lost.The causes of failed implantation were studied from period,locations,complications.After removal of failed implants,second implantation were performed and evaluated.Results Among the 52 lost implants,85% of failed implatation happened in the healing period before reconstruction.In dental areas in which the first implantation failure occurred,the maxillary first molar area was the area where the failure occurred most frequently.The common complications were： puncture of maxillary sinus,fracture of bone wall.In cases with delayed replacement,the average interval between removal and second implatation was 3-6 months.Conclusions Osseointegration is a key factor in implantation.Systemic and local risk factors,were osteoporosis,periodontitis and bone amount.Meanwhile,second implantation was similar to the previous surgeny in clinical efficacy.