54颗种植体早期失败原因分析及影响因素研究

Analysis of the causes of early failure of 54 implants and study of influencing factors

目的分析种植体早期失败原因及可能的影响因素,提高对种植预后的预测性,为临床减少种植体失败提供理论依据。方法选择中国医科大学附属口腔医院种植中心2005年1月至2017年12月种植体早期失败病例,分析其失败原因并评价与种植体早期失败相关的患者自身、种植体及外科手术因素。结果自2005年1月至2017年12月,共7250例患者于我科接受种植修复治疗,共计植入种植体11 534颗。截至2018年3月底,明确记录的早期失败患者有47例,共计脱落54颗种植体,其早期失败率为0.47%。在单因素分析中有统计学意义的影响因素分别是性别、种植部位、缺牙原因、缺牙区骨密度、种植体长度、是否行骨挤压术及上颌窦外侧壁开窗术(P <0.05)。结论种植体早期失败主要由骨结合不良所致,而经单因素分析提示与其相关的因素多为患者自身因素及外科手术因素。故在临床上应严格筛选适应证,对于高风险者术前应给予充分交代;在手术过程中应严格遵守手术规则,根据患者缺失牙的具体情况来制定个性化的手术方案,选择合适的附加手术,尽可能将种植体失败的风险降到最低。

Objective To analyze the causes of early implant failure and its possible influencing factors,to improve the prediction of implant prognosis,and to provide a theoretical basis for clinically reducing implant failure.Methods From January 2005 to December 2017,patients with early implant failure were selected from Center of Oral Implantology,Hospital of Stomatology affiliated to China Medical University,and the causes of early implant failure were analyzed;the patients themselves,implant and surgical factors related to early implant failure were evaluated.Results Totally 7250 patients received implant repair treatment in our department,with a total of 11534 implants. By the end of March 2018,47 cases of early failure had been explicitly recorded,with a total of 54 implants falling off,with an early failure rate of 0.47%. In the univariate analysis,the influencing factors with statistical significance were gender,implant site,cause of tooth loss,bone density,implant length,whether to perform bone osteotome techinque or lateral approach of sinus floor elevation(P < 0.05).Conclusion Early implant failure is mostly caused by poor osseointegration. However,single factor analysis suggests that most of the related factors are patients′own factors and surgical technical factors.Therefore,the indications should be strictly selected in clinical practice,and the high-risk patients should have a fully understanding before surgery,and the operation rules should be strictly observed in the process of surgery. The personalized operation plans should be made according to the specific situation of patients with missing teeth,and appropriate additional surgery should be selected to minimize the risk of implant failure as far as possible.