완전무치악 환자에서 고정성 임플란트 하이브리드 수복물의 임상성적
Clinical outcomes of implant supported fixed-hybrid prostheses in the fully edentulous arches
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연구 목적: 이 연구의 목적은 완전무치악 환자에서 임플란트 지지 고정성 하이브리드 수복물로 수복한 환자의 임상성적을 알아보는 것이다. 연구 대상 및 방법: 분당서울대병원에서 2003년 10월부터 2009년 11월 사이에 4-6개의 임플란트 지지 고정성 하이브리드 수복물로 수복을 하고 1년 이상 기능한 환자를 대상으로 하였다. 방사선 사진상에서 변연골 흡수량을 측정하고 성별, 해부학적 위치(상악 대 하악), 대합치, 하중시기, 식립 경사도에 따른 차이를 비모수 검정(Mann-Whitney U test) 하고, 외팔보의 길이에 따른 영향을 회귀분석하였으며 합병증을 조사하였다. 유의 수준P<.05로 검정하였다. 결과: 총 16명, 16개 수복물에서 84개의 임플란트의 평균 28개월 후의 골흡수량은 0.53 ± 0.39 mm였다. 환자의 성별, 해부학적 위치(상악 대 하악), 대합치, 하중시기에 따른 골흡수량의 유의차는 관찰되지 않았으며(P>.05) 회귀분석 결과 외팔보의 길이와 외팔보 인접 최후방 임플란트의 골흡수량 사이에도 유의성이 없었다(P>.05). 16명중 11명의 환자에서 합병증이 발생하였으며 전장재 파절과 인공치 탈락이 가장 많았다. 결론: 짧은 기간의 후향적 연구라는 한계 내에서, 임플란트 지지 고정성 하이브리드 수복물의 평균 골흡수는 매우 적었지만 높은 빈도의 합병증 발생을 보였다. 외팔보 인접 최후방 임플란트의 경사와 관계 없이 외팔보 인접 최후방 임플란트보다 나머지 전방부 임플란트의 변연골 흡수량이 유의하게 컸다. 모든 증례의 외팔보 길이(< 17 mm)는 외팔보 인접 최후방 임플란트 변연골 흡수량에 영향을 주지 않았다.
Abstract
Purpose: The aim of this study was to evaluate clinical outcomes of implant supported fixed-hybrid prostheses (FHP) in the fully edentulous arches. Materials and methods: Patients in this retrospective study were restored with fixed-hybrid prostheses supported by 4 to 6 implants and functioned more than 1 year of loading. Outcome measures were marginal bone change of implant related with sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients, tilting of posterior implant by Mann-Whitney U test and cantilever length of superstructure by regression analysis, and complication rates. Significance level was set P<.05. Results: A total number of 84 implants (16 restorations) placed in 16 patients were observed for 28 months and mean marginal bone loss was 0.53 ± 0.39 mm. There were no differences of marginal bone loss according to sex, anatomical location (maxilla vs. mandible), opposing teeth, loading time of patients (P>.05), and cantilever length was not significantly related with a marginal bone loss of implant next to cantilever (P>.05). Complication was shown in 11 patients and veneer fracture and dislodging of artificial teeth were most prevalent. Conclusion: Within the limitations of this study, although marginal bone loss of FHP was very little, complication rates were high. Irrespective of tilting of most posterior implants, marginal bone loss of most posterior implants next to cantilever was less than those of the other implants positioned anteriorly. Cantilever length (<17 mm) did not affect a marginal bone loss of most posterior implants.
참고문헌 (32)
- Wennerberg A, "Current challenges in successful rehabilitation with oral implants", J Oral Rehabil, 38, pp.286~294 (2011)
- Park HS, "Implant overdenture & fixed complete prosthesis" (2005), Well Pub Co
- Ortorp A, "Clinical experiences of computer numeric control-milled titanium frameworks supported by implants in the edentulous jaw: a 5-year prospective study", Clin Implant Dent Relat Res, 6, pp.199~209 (2004)
- Jemt T, "Mucosal topography around implants in edentulous upper jaws. Photogrammetric threedimensional measurements of the effect of replacement of a removable prosthesis with a fixed prosthesis", Clin Oral Implants Res, 5, pp.220~228 (1994)
- Jemt T, "Implant-supported welded titanium frameworks in the edentulous maxilla: a 5-year prospective multicenter study", Int J Prosthodont, 15, pp.544~548 (2002)
- Eliasson A, "Five-year results with fixed complete-arch mandibular prostheses supported by 4 implants", Int J Oral Maxillofac Implants, 15, pp.505~510 (2000)
- Lindquist LW, "A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss", Clin Oral Implants Res, 7, pp.329~336 (1996)
- Attard NJ, "Long-term treatment outcomes in edentulous patients with implant-fixed prostheses: the Toronto study", Int JProsthodont, 17, pp.417~424 (2004)
- Makkonen TA, "A 5-year prospective clinical study of Astra Tech dental implants supporting fixed bridges or overdentures in the edentulous mandible", Clin Oral Implants Res, 8, pp.469~475 (1997)
- Bryant SR, "the type of implant prosthesis affect outcomes for the completely edentulous arch?", Int J Oral Maxillofac Implants, 22, pp.117~139 (2007)
- Sanna A, "Successful outcome of splinted implants supporting a 'planned' maxillary overdenture: a retrospective evaluation and comparison with fixed full dental prostheses", Clin Oral Implants Res, 20, pp.406~413 (2009)
- Malo P, "A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up", J Am Dent Assoc, 142, pp.310~320 (2011)
- Kim Y, "Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale", Clin Oral Implants Res, 16, pp.26~35 (2005)
- Ha¨lg GA, "Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers", Clin Oral Implants Res, 19, pp.983~990 (2008)
- Wennstro¨m J, "Bone level change at implant-supported fixed partial dentures with and without cantilever extension after 5 years in function", J Clin Periodontol, 31, pp.1077~1083 (2004)
- Ohkubo C, "Does the presence of antagonist remaining teeth affect implant overdenture success? A systematic review", J Oral Rehabil, 37, pp.306~312 (2010)
- Shackleton JL, "Survival of fixed implant-supported prostheses related to cantilever lengths", J Prosthet Dent, 71, pp.23~26 (1994)
- Rangert B, "Forces and moments on Branemark implants", Int J Oral Maxillofac Implants, 4, pp.241~247 (1989)
- Rodriguez AM, "Cantilever and implant biomechanics: a review of the literature. Part 1", J Prosthodont, 3, pp.41~46 (1994)
- Blanes RJ, "A 10-year prospective study of ITI dental implants placed in the posterior region. I: Clinical and radiographic results", Clin Oral Implants Res, 18, pp.699~706 (2007)
- Aglietta M, "A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years", Clin Oral Implants Res, 20, pp.441~451 (2009)
- Capelli M, "Immediate rehabilitation of the completely edentulous jaw with fixed prostheses supported by either upright or tilted implants: a multicenter clinical study", Int J Oral Maxillofac Implants, 22, pp.639~644 (2007)
- De Kok IJ, "Comparison of three-implant-supported fixed dentures and two-implant-retained overdentures in the edentulous mandible: a pilot study of treatment efficacy and patient satisfaction", Int J Oral Maxillofac Implants, 26, pp.415~426 (2011)
- Malo′P, "The rehabilitation of completely edentulous maxillae with different degrees of resorption with four or more immediately loaded implants: a 5-year retrospective study and a new classification", Eur J Oral Implantol, 4, pp.227~243 (2011)
- Zampelis A, "Tilting of splinted implants for improved prosthodontic support: a two-dimensional finite element analysis", J Prosthet Dent, 97, pp.S35~43 (2007)
- Kim KS, "Biomechanical comparison of axial and tilted implants for mandibular full-arch fixed prostheses", Int J Oral Maxillofac Implants, 26, pp.976~984 (2011)
- Ogawa T, "Effect of tilted and short distal implants on axial forces and bending moments in implants supporting fixed dental prostheses: an in vitro study", Int J Prosthodont, 23, pp.566~573 (2010)
- Misch CE, "Mechanical properties of trabecular bone in the human mandible: implications for dental implant treatment planning and surgical placement", J Oral Maxillofac Surg, 57, pp.700~708 (1999)
- Bergkvist G, "Immediate loading of implants in the edentulous maxilla: use of an interim fixed prosthesis followed by a permanent fixed prosthesis: a 32-month prospective radiological and clinical study", Clin Implant Dent Relat Res, 11, pp.1~10 (2009)
- Brosky ME, "The anterior cantilever in the implant-supported screw-retained mandibular prosthesis", J Prosthet Dent, 89, pp.244~249 (2003)
- Feine JS, "Within-subject comparisons of implant-supported mandibular prostheses: choice of prosthesis", J Dent Res, 73, pp.1105~1111 (1994)
- Preciado A, "Differences in impact of patient and prosthetic characteristics on oral health-related quality of life among implantretained overdenture wearers", J Dent, 40, pp.857~865 (2012)