내부연결 임플란트의 보철 수복 후 성공률에 미치는 위험요소에 관한 10년간의 후향적 연구
A 10-year retrospective study on the risk factors affecting the success rate of internal connection implants after prosthetic restoration
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목적: 본 연구의 목적은 임플란트 보철물의 종류 및 특성과 생존율 분석을 통해 성공률을 높이는데 도움이 되는 데에 있다. 대상 및 방법: 원광대학교 치과대학 산본치과병원에서 2011~2020년에 식립한 임플란트 중 한 명의 보철전문의에 의해 수복된 사례에 대하여 그 특성과 실패에 대한 상관관계 등을 조사하였다. 실패의 원인은 골유착 실패, 임플란트주위염, 고정체 파절, 지대주 파절, 나사 파절, 나사 풀림, 보철물 파절, 보철물 유지력 상실 등으로 분류했다. 보철방식, 캔틸레버 여부, 식립 위치 등과 임플란트 실패와의 연관성을 분석했다. 결과 분석은 SPSS ver 25.0 (IBM, Chicago, IL, USA)을 이용하여 Chi-square test, Kaplan-Meier 생존분석 등을 통하여 도출했다. 결과: 총 2587개의 임플란트가 식립되었으며, 그 중 1141개의 임플란트가 단일관(Single Crown)으로, 1446개의 임플란트가 고정성 국소의치(Fixed Partial Denture)로 수복되었고 누적생존율은 88.1%이었다. SC의 성공률은 86.2% (984개), FPD의 성공률은 89.6% (1295개)로 통계적으로 유의한 차이를 보였으며 그 중 유의한 차이가 있었던 요인은 지대주 파절, 나사 파절, 나사 풀림 등이었다 (P < .05). 결론: 10년간의 추적조사 결과 생물학적인 요인보다는 생역학적인 요인으로 인한 실패가 더 많이 발생했고 임플란트의 성공률은 보철방식 별로 상이했으며 영향을 미치는 요인도 상이했다. 추후 임플란트의 성공에 관한 추가적인 연구가 더 필요할 것이다. (대한치과보철학회지 2023;61:113-24)
Abstract
Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.
참고문헌 (41)
- Levin L, "Long-term success of implants replacing a single molar", J Periodontol, 77, pp.1528~1532 (2006)
- Levin L, "Aesthetic versus surgical success of single dental implants : 1-to 9-year follow-up", Pract Proced Aesthet Dent, 17, pp.533~538 (2005)[DOI]
- Brånemark PI, "Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period", Scand J Plast Reconstr Surg Suppl, 16, pp.1~132 (1977)
- Greenstein G, "Failed dental implants : diagnosis, removal and survival of reimplantations", J Am Dent Assoc, 145, pp.835~842 (2014)
- Smith DE, "Criteria for success of osseointegrated endosseous implants", J Prosthet Dent, 62, pp.567~572 (1989)
- Adell R, "A 15-year study of osseointegrated implants in the treatment of the edentulous jaw", Int J Oral Surg, 10, pp.387~416 (1981)
- Wittneben JG, "Complication and failure rates with implant-supported fixed dental prostheses and single crowns : a 10-year retrospective study", Clin Implant Dent Relat Res, 16, pp.356~364 (2014)
- Moy PK, "Dental implant failure rates and associated risk factors", Int J Oral Maxillofac Implants, 20, pp.569~577 (2005)
- Jemt T, "Associations between early implant failure, patient age, and patient mortality : a 15-year follow-up study on 2, 566patients treated with implant-supported prostheses in the edentulous jaw", Int J Prosthodont, 30, pp.189~197 (2017)
- Manor Y, "Characteristics of early versus late implant failure : a retrospective study", J Oral Maxillofac Surg, 67, pp.2649~2652 (2009)
- Herrmann I, "Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures", Int J Oral Maxillofac Implants, 20, pp.220~230 (2005)
- Brägger U, "Technical and biological complications", failures with single crowns and fixed partial dentures on implants : a 10-year prospective cohort study, 2005, pp.16, 326~334
- Pjetursson BE, "Prosthetic treatment planning on the basis of scientific evidence", J Oral Rehabil, 35, pp.72~79 (2008)
- Göthberg C, "Complications after treatment with implant-supported fixed prostheses : a retrospective study", Int J Prosthodont, 16, pp.201~207 (2003)
- Goodacre CJ, "Clinical complications with implants and implant prostheses", J Prosthet Dent, 90, pp.121~132 (2003)
- Moheng P, "Clinical and biologic factors related to oral implant failure : a 2-year follow-up study", Implant Dent, 14, pp.281~288 (2005)
- Dieter Busenlechner, "Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis", Journal of Periodontal & Implant Science, 44(3), pp.102~108 (2014), 대한치주과학회
- Muley N, "Evolution of external and internal implant to abutment connection", Int J Oral Implantol Clin Res, 3, pp.122~129 (2012)
- Prithviraj DR, "The evolution of external and internal implant–abutment connections : A review", International Dental Research, 2, pp.37~42 (2012)
- Lemos CAA, "Comparison of external and internal implant-abutment connections for implant supported prostheses. A systematic review and meta-analysis", J Dent, 70, pp.14~22 (2018)
- 이유승, "Comparison of implant component fractures in external and internal type: A 12-year retrospective study", The Journal of Advanced of Prosthodontics, 10(2), pp.155~162 (2018), 대한치과보철학회[DOI]
- Lazzara RJ, "Platform switching : a new concept in implant dentistry for controlling postrestorative crestal bone levels", Int J Periodontics Restorative Dent, 26, pp.9~17 (2006)
- Howe MS, "Long-term(10-year)dental implant survival : A systematic review and sensitivity meta-analysis", J Dent, 84, pp.9~21 (2019)
- Lekholm U, "Survival of the Brånemark implant in partially edentulous jaws : a 10-year prospective multicenter study", Int J Oral Maxillofac Implants, 14, pp.639~645 (1999)
- Kapoor R, "Retention of implant supported metal crowns cemented with different luting agents : a comparative invitro study", J Clin Diagn Res, 10, pp.ZC61~ZC64 (2016)
- Misch CE, "Consideration of biomechanical stress in treatment with dental implants", Dent Today, 25, pp.80~ (2006)
- Bidez MW, "Force transfer in implant dentistry : basic concepts and principles", J Oral Implantol, 18, pp.264~274 (1992)
- Abou-Ayash S, "Impact of prosthetic material on mid-and long-term outcome of dental implants supporting single crowns and fixed partial dentures : A systematic review and meta-analysis", Eur J Oral Implantol, 10, pp.47~65 (2017)
- Heintze SD, "Survival of zirconia-and metal-supported fixed dental prostheses : a systematic review", Int J Prosthodont, 23, pp.493~502 (2010)
- Bryant SR, "The effects of age, jaw site, and bone condition on oral implant outcomes", Int J Prosthodont, 11, pp.470~490 (1998)
- Levin L, "Periodontal disease as a risk for dental implant failure over time : a long-term historical cohort study", J Clin Periodontol, 38, pp.732~737 (2011)
- Jemt T, "Fixed implant-supported prostheses in the edentulous maxilla. A five-year follow-up report", Clin Oral Implants Res, 5, pp.142~147 (1994)
- Boyne PJ, "Grafting of the maxillary sinus floor with autogenous marrow and bone", J Oral Surg, 38, pp.613~616 (1980)
- Misch CE, "Implant-protected occlusion : a biomechanical rationale", Compendium, 15, pp.1330~ (1994)
- Papavasiliou G, "Three-dimensional finite element analysis of stress-distribution around single tooth implants as a function of bony support, prosthesis type, and loading during function", J Prosthet Dent, 76, pp.633~640 (1996)
- Soliman TA, "Assessment of stress distribution around implant fixture with three different crown materials", Tanta Dent J, 12, pp.249~258 (2015)
- Himmlová L, "Influence of implant length and diameter on stress distribution : a finite element analysis", J Prosthet Dent, 91, pp.20~25 (2004)
- Chuang SK, "Kaplan-Meier analysis of dental implant survival : a strategy for estimating survival with clustered observations", J Dent Res, 80, pp.2016~2020 (2001)
- Lin CL, "Biomechanical interactions in tooth-implant-supported fixed partial dentures with variations in the number of splinted teeth and connector type : a finite element analysis", Clin Oral Implants Res, 19, pp.107~117 (2008)
- Yokoyama S, "The influence of implant location and length on stress distribution for three-unit implant-supported posterior cantilever fixed partial dentures", J Prosthet Dent, 91, pp.234~240 (2004)
- Simonis P, "Long-term implant survival and success : a 10-16-year follow-up of non-submerged dental implants", Clin Oral Implants Res, 21, pp.772~777 (2010)