种植体折裂的发生率及相关风险因素

doi:10.13701/j.cnki.kqyxyj.2023.04.009

摘要/Abstract

摘要： 目的: 分析种植体负重不同时间后发生折裂的原因,评估其风险因素,探讨预防种植体折裂的临床策略。方法: 纳入2009年7月~2020年12月在郑州大学第一附属医院口腔种植科就诊的2492例种植患者,共植入4823颗种植体,共发现8例患者9枚种植体折裂。根据患者的病例情况,归纳分析影响种植体折裂的危险因素并探讨预防措施。结果: 8个患者共9枚种植体出现了种植体折裂,平均使用时间为(7.2±3.19)年,患者种植体折裂时的年龄为(55.5±11.13)岁,随访期间种植体折裂的发生率为0.18%(9/4823)。结论: 种植体折裂前的临床症状可以预测种植体折裂,若观察到这些临床症状,可及时采取适当的临床治疗,种植体折裂与种植体直径、修复体类型、患者副功能等因素有关。

关键词: 种植体, 种植体折裂, 种植体并发症, 机械并发症

Abstract: Objective: To analyze the cause of implant fracture after different periods of load, evaluate the risk factors, and explore the clinical strategies to prevent implant fracture. Methods: A total of 2492 patients(with 4823 implants)treated in the Department of Oral Implantology, the First Affiliated Hospital of Zhengzhou University from July 2009 to December 2020 were included. The patients' medical records and the X-ray films were used to analysis the risk factors affecting implant fracture and discuss the preventive measures. Results: Eight patients with 9 implants were found to occur the implant fractures. The average loading time of the implants was (7.2±3.19) years, the age of the patients at the time of implant fracture was (55.5±11.13) years, the incidence of implant fracture during follow-up was 0.18% (9/4823). Conclusion: The clinical symptoms before implant fracture can predict implant fracture. If the clinical symptoms are observed, appropriate clinical treatment should be taken in time. Implant diameter, repair method, patient's parafunctions were the influencing factors of implant fracture.

Key words: dental implants, implant fracture, implant complication, mechanical complications

张艳靖, 许嘉琳, 朱慧琳, 周弘. 种植体折裂的发生率及相关风险因素[J]. 口腔医学研究, 2023, 39(4): 332-335.

ZHANG Yanjing, XU Jialin, ZHU Huilin, ZHOU Hong. Incidence of Implant Fracture and Related Risk Factors[J]. Journal of Oral Science Research, 2023, 39(4): 332-335.

参考文献

[1] Al Quran FA, Rashan BA, Al-Dwairi ZN. Management of dental implant fractures. A case history [J]. J Oral Implantol, 2009, 35(4):210-214.
[2] Liaw K, Delfini RH, Abrahams JJ. Dental implant complications [J]. Semin Ultrasound CT MR, 2015, 36(5):427-433.
[3] Lee DW, Kim NH, Lee Y, et al. Implant fracture failure rate and potential associated risk indicators: an up to 12-year retrospective study of implants in 5,124 patients [J]. Clin Oral Implants Res, 2019, 30(3):206-217.
[4] Pjetursson BE, Tan K, Lang NP, et al. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years [J]. Clin Oral Implants Res, 2004, 15(6): 667-676.
[5] Alssadi G, Quiryen M, Komerek A, et al. Impact of local and systemic factors on the incidence of oral implant failure, up to abutment connection [J]. J Clin Periodontol, 2007, 34(7):610-617.
[6] Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period [J]. Scand J Plast Reconstr Surg Suppl, 1977, 16:1-132.
[7] Velasquez-Plata D, Lutonsky J, Oshida Y. A close-up look at an implant fracture: a case report [J]. Int J Periodontics Restorative Dent, 2002, 22(5):483-491.
[8] Chrcanovic BR, Kisch J, Albrektsson T, et al. Factors influencing the fracture of dental implants [J]. Clin Implant Dent Relat Res, 2018, 20(1):58-67.
[9] Romeo E, Storelli S. Systematic review of the survival rate and the biological, technical, and aesthetic complications of fixed dental prostheses with cantilevers on implants reported in longitudinal studies with a mean of 5 years follow up [J]. Clin Oral Implants Res, 2012, 23(6): 39-49.
[10] Mendonça G, Mendonça DB, Fernandes-Neto AJ, et al. Management of fractured dental implants: a case report [J]. Implant Dent, 2009, 18(1):10-16.
[11] Manor Y, Oubaid S, Mardinger O, et al. Characteristics of early versus late implant failure: a retrospective study [J]. J Oral Maxillofac Surg, 2009, 67(12):2649-2652.
[12] Balshi TJ. An analysis and management of fractured implants: A clinical report [J]. Int J Oral Maxillofac Implants, 1996, 11(5):660-666.
[13] Rangert B, Krogh PH, Langer B, et al. Bending overload and implant fracture: a retrospective analysis [J]. Int J Oral Maxillofac Implants, 1995, 10(3):326-334.
[14] Koller CD, Pereira-Cenci T, Boscato N. Parameters associated with marginal bone loss around implant after prosthetic loading [J]. Braz Dent J, 2016, 27(3):292-297.
[15] Zhou Y, Gao J, Luo L, et al. Does bruxism contribute to dental implant failure? A systematic review and meta-analysis [J]. Clin Implant Dent Relat Res, 2016, 18(2):410-420.
[16] Langer B, Langer L, Herrmann I. The wide fixture: A solution for special bone situations and a rescue for the compromised implant. Part 1 [J]. Int J Oral Maxillofac Implants, 1993, 8(4):400-408.
[17] Shemtov-Yona K, Rittel D, Levin L, et al. Effect of dental implant diameter on fatigue performance. Part Ⅰ: Mechanical behavior [J]. Clin Implant Dent Relat Res, 2014, 16(2):172-177.
[18] Tagger GN, Machtei EE, Horwitz J, et al. Fracture of dental implants: literature review and report of a case [J]. Implant Dent, 2002, 11(2):137-143.
[19] Proceedings of the 4th international symposium on implant dentistry: Focus on esthetics. San Diego, California, January 27-29, 1994. Abstracts [J]. J Prosthet Dent, 1994, 72(6):623-634.
[20] Sánchez-Pérez A, Moya-Villaescusa MJ, Jornet-Garcia A, et al. Etiology, risk factors and management of implant fractures [J]. Med Oral Patol Oral Cir Bucal, 2010, 5(3):e504-e508.
[21] 尉华杰,朱一博,王兴,等.19枚种植体负重不同时间后折裂折断的临床分析[J].中华口腔医学杂志,2018,53(12): 815-820.
[22] Patterson EA, Johns RB. Theoretical analysis of the fatigue life of fixture screws in osseointegrated dental implants [J]. Int J Oral Maxillofac Implants, 1992, 7(1):26-33.
[23] Piattelli A, Piattelli M, Scarano A, et al. Light and scanning electron microscopic report of four fractured implants [J]. Int J Oral Maxillofac Implants, 1998, 13(4):561-564.
[24] McDermott NE, Chuang SK, Woo VV, et al. Complications of dental implants: identification, frequency, and associated risk factors [J]. Int J Oral Maxillofac Implants, 2003, 18(6):848-855.
[25] Maló P, Nobre Md, Lopes A. 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 [J]. Eur J Oral Implantol, 2011, 4(3):227-243.
[26] Chrcanovic BR, Kisch J, Albrektsson T, et al. Bruxism and dental implant treatment complications: a retrospective comparative study of 98 bruxer patients and a matched group [J]. Clin Oral Implants Res, 2017, 28(7):e1-e9.
[27] Pigozzi LB, Rehm DDS, Fagondes SC, et al. Current methods of bruxism diagnosis: A short communication [J]. Int J Prosthodont, 2019, 32(3):263-264.