The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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The effects of local factors on the survival of dental implants: A 19 year retrospective study

임플란트의 생존율에 영향을 미치는 국소적 인자에 대한 19년간의 후향적 연구

  • Kim, Sung-Hoi (Department of Prosthetic Dentistry, The Graduate School, Yonsei University) ;
  • Kim, Sun-Jai (Department of Prosthetic Dentistry, The Graduate School, Yonsei University) ;
  • Lee, Keun-Woo (Department of Prosthetic Dentistry, The Graduate School, Yonsei University) ;
  • Han, Dong-Hoo (Department of Prosthetic Dentistry, The Graduate School, Yonsei University)
  • 김성회 (연세대학교 치과대학 보철학교실) ;
  • 김선재 (연세대학교 치과대학 보철학교실) ;
  • 이근우 (연세대학교 치과대학 보철학교실) ;
  • 한동후 (연세대학교 치과대학 보철학교실)
  • Published : 2010.01.29
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Abstract

Purpose: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. Material and methods: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. Results: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). Conclusions: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

연구 목적: 임플란트의 성공과 실패는 숙주 관련 요인, 위치 관련 요인, 수술 관련 요인, 임플란트 관련 요인, 수복물 관련 요인 등 다양한 인자에 의해 결정된다. 본 연구는 그 중 임플란트의 식립 위치, 골질, 임플란트 표면, 길이 및 직경, 초기 안정성, 보철물 유형이 생존율에 미치는 영향을 평가하여, 임플란트의 예후를 예측하는데 도움을 주고자 한다. 연구 재료 및 방법: 1991년 2월부터 2009년 5월 사이에 연세대학교 치과대학병원에서 5인의 외과의가 임플란트 수술을 시행하고, 1인의 보철 전문의에 의해 보철 수복이 이루어져 적어도 6개월 이상 보철물에 대한 주기적인 검사가 이루어진 879명환자, 2796개의 임플란트에 대한 후향적 연구를 시행하였다. 진료 기록부 및 방사선 사진을 통해 환자의 식립 당시 나이와 성별, 임플란트의 제조회사, 표면, 직경 및 길이, 식립 부위 및 골질, 초기 안정성, 보철물의 유형, 생존 기간에 관한 자료를 수집하였다. 이를 통해, 임플란트의 성공과 실패에 영향을 미치는 국소 인자의 유형, 분포 및 국소 인자와 생존율 간의 관계를 연구하였다. 생존율 분석은 Kaplan-Meier 생존 분석법을 이용하였으며, 평가 인자 내 항목들의 생존율 비교는 Chi-square test를 사용하였다. 또한, 임플란트의 실패 위험성을 평가하기 위해 오즈비 (odds ratio)를 구하였다. 결과: 1. 총 879명에게 식립된 2796개의 임플란트 중 150개가 실패하여 누적 생존율은 94.64%로 나타났다. 그 중 기계 절삭 표면 임플란트의 누적 생존율은 91.76%, 거친 표면 임플란트의 누적 생존율은 96.02% 이었다. 2. 식립위치, 임플란트의 표면 특성, 기계 절삭 표면 임플란트의 직경, 초기 안정성, 보철물 유형, 환자의 연령 및 성별이 생존율에 미치는 영향은 통계학적으로 유의하였다 (P<.05). 3. 식립 부위의 골질, 임플란트 제조사별 거친 표면 특성, 임플란트의 길이 및 기계 절삭 표면을 제외한 거친 표면 임플란트의 직경이 생존율에 미치는 영향은 통계학적으로 유의하지 않았다 (P>.05). 4. 특히, 실패율이 높은 경우는 상악 구치부에 식립 시 (8.84%), 기계 절삭 표면의 임플란트 식립 시 (8.24%), 기계 절삭 표면 임플란트 중 wide 직경을 사용하는 경우 (14.47%), 초기 고정이 불량한 경우 (28.95%), 상악에 implant retained overdenture (기계 절삭 표면 26.69%; 거친 표면 10%) 및 telescopic denture (기계 절삭 표면 100%; 거친 표면 27.27%)로 수복하는 경우, 60-79세 환자에게 식립하는 경우 (6.90%), 남성에게 식립하는 경우 (6.36%) 이었다.

Keywords

References

  1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416. https://doi.org/10.1016/S0300-9785(81)80077-4
  2. Adell R, Eriksson B, Lekholm U, Branemark PI, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5:347- 59.
  3. Buser D, Mericske-Stern R, Bernard JP, Behneke A, Behneke N, Hirt HP, Belser UC, Lang NP. Long-term evaluation of nonsubmerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 1997;8:161-72. https://doi.org/10.1034/j.1600-0501.1997.080302.x
  4. Esposito M, Grusovin MG, Coulthard P, Thomsen P, Worthington HV. A 5-year follow-up comparative analysis of the efficacy of various osseointegrated dental implant systems: a systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants 2005;20:557-68.
  5. Romeo E, Lops D, Margutti E, Ghisolfi M, Chiapasco M, Vogel G. Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system. Int J Oral Maxillofac Implants 2004;19:247- 59.
  6. Han DH, Bae EK. Longitudinal clinical study on the efficacy of osseointegrated dental implants in partially edentulous Korean patients: an 8-years prospective study. J Korean Acad Prosthodont 2001;39:698-708.
  7. Seo JY, Shim JS, Lee JH, Lee KW. Clinical and radiographical evaluation of implant-supported fixed partial prostheses. J Korean Acad Prosthodont 2006;44:394-404.
  8. el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part I. Implant Dent 1999;8:173-85. https://doi.org/10.1097/00008505-199908020-00011
  9. el Askary AS, Meffert RM, Griffin T. Why do dental implants fail? Part II. Implant Dent 1999;8:265-77. https://doi.org/10.1097/00008505-199903000-00008
  10. Albrektsson T, Branemark PI, Hansson HA, Lindstrom J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981;52:155-70. https://doi.org/10.3109/17453678108991776
  11. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 1998;106:721-64. https://doi.org/10.1046/j.0909-8836..t01-6-.x
  12. Tonetti MS, Schmid J. Pathogenesis of implant failures. Periodontol 2000 1994;4:127-38. https://doi.org/10.1111/j.1600-0757.1994.tb00013.x
  13. Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, Feldmann G, Freiberg N, Glantz PO, Kjellman O, et al. Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol 1988;59:287-96. https://doi.org/10.1902/jop.1988.59.5.287
  14. Buser D, Weber HP, Lang NP. Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollowcylinder and hollow-screw implants. Clin Oral Implants Res 1990;1:33-40.
  15. Cochran DL, Buser D, ten Bruggenkate CM, Weingart D, Taylor TM, Bernard JP, Peters F, Simpson JP. The use of reduced healing times on ITI implants with a sandblasted and acid-etched (SLA) surface: early results from clinical trials on ITI SLA implants. Clin Oral Implants Res 2002;13:144-53. https://doi.org/10.1034/j.1600-0501.2002.130204.x
  16. Bryant SR. The effects of age, jaw site, and bone condition on oral implant outcomes. Int J Prosthodont 1998;11:470-90.
  17. Shirota T, Ohno K, Suzuki K, Michi K. The effect of aging on the healing of hydroxylapatite implants. J Oral Maxillofac Surg 1993;51:51-6. https://doi.org/10.1016/S0278-2391(10)80390-8
  18. Smith RA, Berger R, Dodson TB. Risk factors associated with dental implants in healthy and medically compromised patients. Int J Oral Maxillofac Implants 1992;7:367-72.
  19. Schwartz-Arad D, Laviv A, Levin L. Failure causes, timing, and cluster behavior: an 8-year study of dental implants. Implant Dent 2008;17:200-7. https://doi.org/10.1097/ID.0b013e3181777906
  20. Wagenberg B, Froum SJ. A retrospective study of 1925 consecutively placed immediate implants from 1988 to 2004. Int J Oral Maxillofac Implants 2006;21:71-80.
  21. Misch CE. Short dental implants: a literature review and rationale for use. Dent Today 2005;24:64-6, 68.
  22. Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res 2006;17:35-51. https://doi.org/10.1111/j.1600-0501.2006.01349.x
  23. Ivanoff CJ, Gro ¨ndahl K, Sennerby L, Bergstrom C, Lekholm U. Influence of variations in implant diameters: a 3- to 5-year retrospective clinical report. Int J Oral Maxillofac Implants 1999;14:173- 80.
  24. Shin SW, Bryant SR, Zarb GA. A retrospective study on the treatment outcome of wide-bodied implants. Int J Prosthodont 2004;17:52-8.
  25. Meredith N, Shagaldi F, Alleyne D, Sennerby L, Cawley P. The application of resonance frequency measurements to study the stability of titanium implants during healing in the rabbit tibia. Clin Oral Implants Res 1997;8:234-43. https://doi.org/10.1034/j.1600-0501.1997.080310.x
  26. Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res 2007;18:275-80. https://doi.org/10.1111/j.1600-0501.2007.01336.x
  27. Rabel A, Kohler SG, Schmidt-Westhausen AM. Clinical study on the primary stability of two dental implant systems with resonance frequency analysis. Clin Oral Investig 2007;11:257-65. https://doi.org/10.1007/s00784-007-0115-2
  28. Park JH, Lim YJ, Kim MJ, Kwon HB. The effect of various thread designs on the initial stability of taper implants. J Adv Prosthodont 2009;1:19-25 https://doi.org/10.4047/jap.2009.1.1.19
  29. O'Sullivan D, Sennerby L, Meredith N. Measurements comparing the initial stability of five designs of dental implants: a human cadaver study. Clin Implant Dent Relat Res 2000;2:85-92. https://doi.org/10.1111/j.1708-8208.2000.tb00110.x
  30. Alves CC, Neves M. Tapered implants: from indications to advantages. Int J Periodontics Restorative Dent 2009;29:161-7.
  31. Iezzi G, Degidi M, Scarano A, Perrotti V, Piattelli A. Bone response to submerged, unloaded implants inserted in poor bone sites: a histological and histomorphometrical study of 8 titanium implants retrieved from man. J Oral Implantol 2005;31:225-33. https://doi.org/10.1563/1548-1336(2005)31[225:BRTSUI]2.0.CO;2
  32. Kim NS, Vang MS, Yang HS, Park SW, Lim HP. Comparion of stability in titanium implants with different surface topographies in dogs. J Adv Prosthodont 2009;1:47-55 https://doi.org/10.4047/jap.2009.1.1.47
  33. Cochran DL. The evidence for immediate loading of implants. J Evid Based Dent Pract 2006;6:155-63. https://doi.org/10.1016/j.jebdp.2006.04.018
  34. Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90:121-32. https://doi.org/10.1016/S0022-3913(03)00212-9
  35. Bryant SR, MacDonald-Jankowski D, Kim K. Does the type of implant prosthesis affect outcomes for the completely edentulous arch? Int J Oral Maxillofac Implants 2007;22:117-39.
  36. Weber HP, Sukotjo C. Does the type of implant prosthesis affect outcomes in the partially edentulous patient? Int J Oral Maxillofac Implants 2007;22:140-72
  37. Esposito M, Hirsch J, Lekholm U, Thomsen P. Differential diagnosis and treatment strategies for biologic complications and failing oral implants: a review of the literature. Int J Oral Maxillofac Implants 1999;14:473-90.
  38. Weaver AL, Assad DA, Koka S, Eckert SE, Balshe A. The effects of smoking on the survival of smooth- and rough-surface dental implants. Int J Oral Maxillofac Implants 2008;23:1117-22.
  39. Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology. Eur J Oral Sci 1998;106:527- 51. https://doi.org/10.1046/j.0909-8836..t01-2-.x
  40. Rabel A, Kohler SG, Schmidt-Westhausen AM. Clinical study on the primary stability of two dental implant systems with resonance frequency analysis. Clin Oral Investig 2007;11:257-65. https://doi.org/10.1007/s00784-007-0115-2
  41. Chuang SK, Cai T, Douglass CW, Wei LJ, Dodson TB. Frailty approach for the analysis of clustered failure time observations in dental research. J Dent Res 2005;84:54-8. https://doi.org/10.1177/154405910508400109
  42. Weyant RJ, Burt BA. An assessment of survival rates and withinpatient clustering of failures for endosseous oral implants. J Dent Res 1993;72:2-8. https://doi.org/10.1177/00220345930720010201

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