后牙区种植支持单冠长期修复效果及影响因素分析

Long-term restoration outcomes and influencing factors of single crown supported by dental implants in the posterior region

目的:探讨长期行使功能的后牙区种植支持单冠的修复效果以及修复并发症的影响因素。方法:收集2010年1月至2015年12月在郑州大学第一附属医院口腔种植科完成后牙区种植支持单冠修复且行使功能达5 a以上患者的临床资料,计算修复并发症发生率以评估种植治疗效果;采用Logistic回归分析崩瓷、脱粘接和基台及螺丝松动的影响因素。结果:共纳入742例患者,种植修复体1100颗。长期行使功能的修复体中,933颗种植修复体没有发生过任何并发症,修复体成功率为84.8%,945颗种植修复体仍在原位行使功能,修复体存留率为85.9%。主要并发症有崩瓷(7.7%)、脱粘接(6.4%)、基台及螺丝松动(3.8%)、基台及螺丝折断(0.5%)和种植体折断(0.1%)。Logistic回归分析结果显示不良咬合习惯(OR=5.006,95%CI为3.067~8.172,P<0.001)和聚合瓷冠(OR=2.614,95%CI为1.049~6.518,P=0.039)是崩瓷的危险因素;不良咬合习惯(OR=2.987,95%CI为1.596~5.598,P=0.001)、磨牙牙位(OR=6.460,95%CI为1.548~26.953,P=0.010)是脱粘接的危险因素;个性化基台(OR=23.059,95%CI为10.877~48.883,P<0.001)是基台及螺丝松动的危险因素。结论:长期行使功能的后牙区种植支持单冠获得了可预期的成功率,对于修复并发症要早期预防和及时处理。

Aim:To retrospectively analyze the long-term restoration outcomes of single crown supported by dental implants in the posterior region and the influencing factors of prostheses-related complications.Methods:A retrospective analysis was performed based on the medical records of patients who had completed single crown supported by dental implants in the posterior region in the Department of Oral Implantology,the First Affiliated Hospital of Zhengzhou University,from January 2010 to December 2015.All the patients had been using the prostheses for more than 5 years,and the occurrence rate of complications were recorded to evaluate the restoration outcome.Logistic regression was used to analyze the influencing factors of prosthesis-related complications.Results:This study covered 742 patients with 1100 implants.Among the restorations with long-term function,933 implants were not recorded with any complications,and the restoration success rate was 84.8%.Besides,945 implants were still functioning in situ,and the restoration survival rate was 85.9%.The main prosthesis-related complications involved fracture of porcelain(7.7%),loss of retention(6.4%),abutment and screw loosening(3.8%),abutment and screw fracture(0.5%)and implant fracture(0.1%).Among the complications,malocclusion habits(OR=5.006,95%CI was 3.067-8.172,P<0.001)and polymeric ceramic crown(OR=2.614,95%CI was 1.049-6.518,P=0.039)were the influencing factors of fracture of porcelain,malocclusion habits(OR=2.987,95%CI was 1.596-5.598,P=0.001)and grinding teeth positions(OR=6.460,95%CI was 1.548-26.953,P=0.010)were the influencing factors of loss of retention,abutment type(OR=23.059,95%CI was 10.877-48.883,P<0.001)was the influencing factor of abutment and screw loosening.Conclusion:The single crown supported by dental implants in the posterior region with long-term function has achieved a predictable success rate.Early prevention and timely treatment should be emphasized for prosthesis-related complications.