상악동 골 이식술을 동반하여 식립된 임플란트의 변연골변화와 생존률에 관한 후향적 연구
A Retrospective study of the Cumulative Survival Rate and change of peri-implant marginal bone around implants associated with maxillary sinus augmentation
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초록
연구목적: 이 연구는 측방접근법을 통해 상악동 골이식을 시행한 후 임플란트를 식립하였을 때, 누적 생존률 및 성별, 연령별, 이식재, 자가골의 공여부, 술전 잔존골 양, 무치악 형태, 식립 시기, 임플란트 종류, 직경과 길이에 따른 임플란트의 생존률 및 변연골의 방사선학적 결과의 차이를 분석하고자 시행되었다. 연구 재료 및 방법: 상악 구치에 측방접근법을 통해 상악동 골이식술 후 임플란트 보철치료를 시행한 71명을 대상으로 하였으며 표면 처리된 나사모양의 임플란트를 사용하였다. Osseotite (BIOMET 3i, Warsaw, USA), Neoplant (Neobiotec, Seoul, Korea), Br¨anemark (Nobel Biocare, Goteberg, Sweden)과 SSII (Osstem, Busan, Korea)를 사용하였다. 최소 6개월 이상의 기간 관찰 누적 생존률은 Kaplan-Meier 분석법을 이용하였으며 다른 요소에 따른 임플란트의 생존률의 유의 성은 Chi-square test로 검정하였다 결과: 상악동골 이식술이 시행된 모든 증례에서 임플란트 식립이 가능한 골 양이 얻어졌으며92%의 생존률을 보였다 결론: 상악동 골이식술을 시행한 후 임플란트 보철 수복은 자가골 단독 사용시에 자가골과 골대체 물질이 혼합된 것보다 우수한 생존률을 보였다. 지연 식립 하는 경우가 임플란트와 동시에 식립하는 경우보다 생존률이 높았다.
Abstract
Statement of problem: Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone & bone substitute graft has been proven to be a reliable treatment modality, at least in the short term. The aim of this study is to evaluate the factors of implant survival rate associated with maxillary sinus lift with grafts. Material and methods: The sinus floor was augmented with bone grafts derived from modified Caldwell-luctechnique (71 subject, 93 sinus, 180 implants), the autogenous bone or autogenous + Bio-oss. Before implant installation the width and height of the alveolar crest were increased in the first stage procedure in 10 patients while in the other 61 patients augmentation and implant installation could be performed simultaneously width and height of the alveolar crest > 4 mm) or delayed installation. Results: In all case bone volume was sufficients for implant insertion. 14 of 180 inserted implants were lost during follow up and the healing period Patient received implant supported overdenture (5 patients) or fixed bridge (62 patients). Conclusion: Within the limit of the result of this study, we conclude that bone grafting of the floor of the maxillary sinus floor with bone for the insertion of implants might be a reliable treatment modality and the autogenous bone graft and delayed installation method might be the factors for good results.
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