单颌种植即刻修复临时修复体长期戴用可行性及临床并发症危险因素相关性分析

A study on the feasibility of long-term use of single jaw implant immediate prosthesis and the analysis of multiple factors of clinical complications

目的:探讨单颌种植即刻修复临时修复体患者长期戴用的可行性,及临床并发症危险因素相关性分析。方法:选取2010年5月~2018年7月湖北省人民医院口腔科行单颌种植即刻修复治疗的患者100例,回顾性分析患者临床资料和治疗情况。采用多因素Cox回归方法,评估影响修复体折裂的因素。结果:即刻修复体戴用中位时间为17.7个月;戴用最初6个月内,共有30例患者(30%)的38个修复体(28.4%)发生并发症,整个戴用期有54例患者(54%)发生并发症。前牙发生折裂的次数更多,而基托折裂的分布则与之相反;即刻修复体戴用第1年修复体折裂发生概率大于后续年份。多因素分析表明,性别(男)(P=0.021,HR=1.445)、颌位(上)(P=0.019,HR=1.547)、固定对颌牙列(P=0.002,HR=2.477)和修复体纤维加强(P=0.011,HR=0.249)与修复体折裂显著发生密切相关。结论:长期戴用单颌种植即刻修复临时修复体具有较高的并发症发生率,修复体折裂最常见,在第1年内发生率最高,建议术后6个月左右及时更换为终末修复体。

Objective:To investigate the feasibility study of long-term use of temporary prosthesis for immediate repair of single-jaw implant,and the correlation analysis of risk factors for clinical complications.Methods:A total of 100 patients who underwent immediate repair of single-jaw implants in our hospital were selected.The patient data were retrospectively analyzed,and the basic information and treatment status of the patients were recorded.Cox regression analysis was used to analyze the factors of the fracture of the restoration.Results:The median time for immediate restoration was 17.7 months.In the first 6 months of wearing,there were 38 cases(28.4%)of the patients had complications in 30%of the patients,and 54 patients(54%)had complications during the entire wearing period.The anterior teeth have more fractures,and the distribution of the base fractures was opposite.The immediate prosthesis wears the first year of prosthesis fracture probability was greater than the subsequent years.The multivariate analysis showed that the fracture of the prosthesis was significantly correlated with gender(male)(P=0.021,HR=1.445),maxillary position(upper)(P=0.019,HR=1.547),fixed pairs of maxillary dentition(P=0.002,HR=2.477)and prosthesis fiber reinforcement(P=0.011,HR=0.249).Conclusion:Long-term use of single-jaw implant for immediate repair of temporary prosthesis has a higher incidence of complications,among which the most common is prosthesis fracture,with the highest incidence in the first year.It is still recommended to replace the terminal prosthesis in time about 6 months after surgery.