上颌窦底提升术后种植修复的十年临床回顾分析

Ten-year Retrospective Study of Implant Restoration with Maxillary Sinus Floor Elevation

目的:分析不同的影响因素对上颌窦底提升术后种植体存留率的影响及其作用。方法:收集西安交通大学口腔医院种植科2003-11-2016-05间,行上颌窦底提升术种植患者的临床资料,定期规律随访至2018-03,用寿命表法统计累计存留率,用Kaplan-Meier法和Cox回归模型分析不同因素对生存率的影响。结果:共393名患者接受了后牙区上颌窦底提升术,植入共计822枚种植体。寿命表法分析显示,种植体1、3、5、10年的累积存留率分别为99.39%、98.60%、97.76%、97.14%。多因素分析显示,种植体直径、牙周炎、植入扭力、吸烟、中央螺丝状态异常是患者种植失败事件的独立预测因素。结论:上颌窦底提升术是解决上后牙区垂直向骨高度不足的一种稳定、可靠的骨增量手术,10年累积存留率超过97%。对可能的混杂因素进行矫正后,多因素分析显示,种植体直径、牙周炎、植入扭力、吸烟、中央螺丝状态异常可以预测种植体失败。

In this study,the long-term survival rate of implants after maxillary sinus floor elevation was calculated,and the effects of different factors on the survival rate of implants after maxillary sinus floor elevation were analyzed.Methods:The clinical data of 393 implant patients,including 246 males and 147 females,with 822 implants,after maxillary sinus floor elevation surgery from November 2003 to May 2016,were retrospectively analyzed.The patients were followed up regularly until March 2018.The cumulative survival rate was calculated by life table method.The influence of different factors on survival rate was analyzed by Kaplan-Meier method and Cox regression model.Results:Life table analysis showed that the cumulative retention rates of implants in 1-,3-,5-,and 10-year were 99.39%,98.60%,97.76%and 97.14%,respectively.Multivariate analysis showed that implant dimension,periodontitis,implant torque,smoking and abnormal central screw status were independent predictors of implant failure.Conclusion:Maxillary sinus floor elevation is a long-term stable and reliable bone augmentation surgery for the treatment of vertical bone height deficiency in the upper and posterior teeth.The 10-year cumulative survival rate is over 97%.After correction of possible confounding factors,multivariate analysis showed that implant dimension,periodontitis,implant torque,smoking and abnormal central screw status,could be related to implant failure.