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  • 學位論文

混合表面OSSEOTITE牙科植體十年回溯性臨床研究

A 10-year Retrospective Clinical Study of Hybrid Surfaces OSSEOTITE Implants

指導教授 : 王震乾

摘要


中文摘要 研究目的:探討OSSEOTITE外六角混合表面牙科植體的長期累積存活率、影響植體失敗相關因子以及植體邊緣骨吸收情況。 研究方法:記錄高雄醫學大學植牙門診自西元1994至2005十年間植入牙科植體患者。於西元2005年1月至2006年9月間,自273位患者中,選取有定期回診且符合此次實驗標準之93位部份或全口缺牙患者,共植入206顆OSSEOTITE植體。拍攝環口X光片、牙科根尖片,記錄植體邊緣骨吸收狀況、有否放射線透射病灶,骨移植與否、時機、種類,植體周圍囊袋探測深度,口內軟組織(有否角化牙齦),對咬和贋復體設計、材質。植體邊緣骨吸收量則使用電腦軟體測量以平行法拍攝之牙科根尖片,將最近ㄧ次測量值與base line數值相比較。統計分析部份,以Kaplan-Meier analysis計算植體存活率並與Log-rank test結果比較影響植體存活之相關因子;臨床因子影響植體存活的相對風險(Relative Risk)則使用Cox regression methods分析。 結果:93位患者(男52位,女41位),植體置入時平均年齡57.1歲(36到83歲)。平均追蹤時間5.72±2.76年(1.2到11.8年)。206顆植體中有9顆植體失敗(7顆失敗於承受咬合力之後)。五年及十年植體存活率皆為95.52%。植體寬徑、植體長度、接受骨移植部位及骨移植時機與植體失敗在統計上有顯著相關(p<.05)。植體承受咬合力後第1年為0.29±0.56公釐,之後每年的平均邊緣骨吸收約為0.29±0.56公釐,10年追蹤觀察期間的平均邊緣骨吸收為0.89±0.81公釐。 結論:本研究結果顯示,OSSEOTITE外六角植體與已發表文獻比較有可接受的長期存活率(95.52%)及邊緣骨吸收,植體寬徑、長度及骨移植有否與時機為影響植體存活率因素。

並列摘要


Abstract Objectives: This study reports the long-term cumulative survival rates (CSR), the factors associated with failure, and the marginal bone loss of external hexed hybrid surface OSSEOTITE dental implants. Materials & Methods: The recall of patients at implant clinic of Kaoshiung Medical University Hospital started in January, 2005 and lasted all the way until September, 2006. Among 273 patients, 206 implants in 93 patients with regular follow-ups met the inclusion criteria, and are therefore the basis of the present study. The Amount of marginal bone loss around the implants was measured from peri-apical radiographs based on paralleling technique using computer software. The baseline radiograph was compared with the most recent one. Clinical evaluation as peri-implant soft and hard tissue conditions, prosthesis designs and questionnaires were applied during the periods of recall. The Kaplan-Meier estimate was applied to calculate implants survival rates, and compared to the results of Log-rank tests for risk factors. The relative risks (RR) of implants failure for clinical factors were determined by Cox-regressions. Results: The average age of the 93 patients (52 Males and 41 females) at the time of implants insertion was 57.1 years old (36 to 83 years old). Mean follow-ups is 5.72±2.76 years (1.2 to 11.8 years). Nine of 206 implants were failures (7 after occlusal loading). The 5-year CSR was 95.52% and the 10-year CSR was 95.52%. Implant diameter, implant length, bone grafting and bone grafting timing were correlated with implant survival (p<.05). The mean marginal bone loss was 0.29±0.56 mm after the first year of function, 0.29±0.56 mm annually, and 0.89±0.81 mm during 10-year follow-up. Conclusions: Acceptable survival rate with minimal marginal bone loss around external hexed OSSEOTITE implant was revealed in this long-term study. Higher failure rates were noted in patients whom inserted short implant (≦10mm) or received bone grafting procedures prior to implant placement.

參考文獻


參考文獻
1. Adell R, Lekholm U, Rockler B, et al. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10(6):387-416.
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3. Lekholm U, Gunne J, Henry P, et al. Survival of the Branemark implant in partially edentulous jaws: a 10-year prospective multicenter study. Int J Oral Maxillofac Implants 1999;14(5):639-45.
4. Branemark PI, Adell R, Breine U, et al. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969;3(2):81-100.

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