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中华口腔医学研究杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 21 -26. doi: 10.3877/cma.j.issn.1674-1366.2022.01.004

论著

老年患者种植修复成功率与满意度的随访研究
朱珠1, 顾烨辰2, 朱庆萍3, 何峰3, 张玮3,()   
  1. 1. 中国人民解放军东部战区空军医院口腔科,南京 210002;南京医科大学附属口腔医院特诊科,江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心,南京 210009
    2. 苏州口腔医院,苏州 215008
    3. 南京医科大学附属口腔医院特诊科,江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心,南京 210009
  • 收稿日期:2021-12-14 出版日期:2022-02-01
  • 通信作者: 张玮

A follow-up study on the success rate and satisfaction of implant repair in elderly patients

Zhu Zhu1, Yechen Gu2, Qingping Zhu3, Feng He3, Wei Zhang3,()   

  1. 1. Stomatology Outpatient of the Air Force from Eastern Theater of PLA, Nanjing 210002, China; Jiangsu Key Laboratory of Oral Diseases, Special Clinical Department, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210009, China
    2. Suzhou Stomatology Hospital, Suzhou 215008, China
    3. Jiangsu Key Laboratory of Oral Diseases, Special Clinical Department, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210009, China
  • Received:2021-12-14 Published:2022-02-01
  • Corresponding author: Wei Zhang
  • Supported by:
    Natural Science Foundation of Jiangsu Province(BK20171057)
引用本文:

朱珠, 顾烨辰, 朱庆萍, 何峰, 张玮. 老年患者种植修复成功率与满意度的随访研究[J]. 中华口腔医学研究杂志(电子版), 2022, 16(01): 21-26.

Zhu Zhu, Yechen Gu, Qingping Zhu, Feng He, Wei Zhang. A follow-up study on the success rate and satisfaction of implant repair in elderly patients[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2022, 16(01): 21-26.

目的

评估老年人种植修复的成功率和满意度,探讨可能影响种植体成功率的危险因素。

方法

本研究以2015—2018年在南京医科大学附属口腔医院特诊科就诊并进行种植牙修复治疗的老年患者(≥60岁)为研究对象。种植体植入时的平均年龄为(67.47 ± 6.57)岁,共101例病例、241颗种植体。在种植修复完成后的3年内对其进行随访,记录种植体的成功率和牙周情况,并分析影响种植体成功率的危险因素。同时采用问卷调查的方法,调查患者对种植牙的满意度。采用线性回归模型及t检验来对数据进行统计分析。

结果

种植体总成功率为96%,失败率为4%(10颗种植体),3年随访期间,出血指数、菌斑指数、牙龈指数均有改善。种植体的成功率与多种因素有关,尤其是患者的牙周状态、吸烟程度以及咬合力大小等。231颗种植体在3个月、6个月、1年、2年、3年的平均边缘骨吸收量为(0.45 ± 0.61)、(0.51 ± 0.55)、(0.54 ± 0.48)、(0.60 ± 0.06)和(0.67 ± 0.25)mm,种植体周围平均探诊深度为(2.60 ± 1.42)mm,平均边缘骨吸收(0.55 ± 0.16)mm。线性回归分析结果显示,r = -0.81、SE = 0.75、R2 = 0.50、P = 0.78,种植体周围牙周袋深度越大,种植体边缘骨丢失越多。患者对种植修复的总体满意度为(9.20 ± 0.94)分。

结论

在满足种植适应证的前提下,术后避免咬合力过大、尽量减少吸烟及注意牙周的维护对老年缺牙患者进行种植修复的成功率很高,且患者满意度较高,可以获得良好的修复效果。

Objective

To evaluate the success rate and satisfaction of implant repair in the elderly, and to explore the risk factors that may affect the success rate of implants.

Methods

In this study, elderly patients (≥60 years old) who were treated with implant restoration in the special clinic of Stomatology Hospital Affiliated to Nanjing Medical University from 2015 to 2018 were taken as the study objects. The average age of implant implantation was (67.47 ± 6.57) years old. There were 101 cases and 241 implants. They were followed up within 3 years after the completion of implant restoration. The success rate of implant and periodontal condition were recorded, and the risk factors affecting the success rate of implant were analyzed. At the same time, questionnaire survey was used to investigate patients′ satisfaction with implant restorations. Linear regression model and t-test were used to analyze the data.

Results

The total success rate of implants was 96%, and the failure rate was 4% (10 implants) . During the 3-year follow-up, the bleeding index (BI) , plaque index (PLI) and gingival index (GI) were improved. The success rate of implants was related to many factors, especially the periodontal states, smoking degree and bite force of patients. The average marginal bone resorption of 231 implants at 3 months, 6 months, 1 year, 2 years and 3 years was (0.45 ± 0.61) , (0.51 ± 0.55) , (0.54 ± 0.48) , (0.60 ± 0.06) and (0.67 ± 0.25) mm. The average depth of periodontal pocket around the implant was (2.60 ± 1.42) mm, and the average absorption of marginal bone was (0.55 ± 0.16) mm. Linear regression analysis showed that r = -0.81, SE = 0.75, R2 = 0.50, P = 0.78. The greater the depth of periodontal pocket around the implant, the more bone loss at the edge of the implant. The overall satisfaction of patients with implant repair was 9.20 ± 0.94.

Conclusions

The results show that, on the premise of meeting the implant indications, avoiding excessive bite force, reducing smoking intake and paying attention to periodontal maintenance, both the success rate of implant repair and the satisfaction for elderly patients with missing teeth were very high, and a good repair effect can be obtained.

图1 种植义齿满意度患者自评表
图2 老年缺牙患者于种植术后3个月内出现种植体周围炎 箭头示种植体周围骨密度降低,边缘骨与种植体结合点至种植体与基台的结合点的距离大于2 mm,提示种植体周围炎的发生。
图3 老年缺牙患者永久修复18个月复查全颌曲面断层片 示12种植体发生折裂,22种植体中央螺丝折裂,种植体周围骨结合良好,牙槽骨均未有明显的骨吸收,主要原因可能是患者后牙多数缺失、咀嚼效率低,前牙承担大部分咀嚼功能,咬合力过大。
表1 96例(231颗)种植成功老年患者牙周复查结果(颗)
图4 101例老年缺牙患者种植修复术后3年平均边缘骨吸收量与种植体牙周探诊深度的相关性散点图
图5 老年患者种植修复典型病例治疗前后图像资料 A:术前CBCT影像,示患者骨量尚可,可行种植手术;B:安装复合基台后的口内照,示种植体周围牙龈健康;C:最终口内修复效果面照;D:最终口内修复效果正面咬合照,示患者种植牙稳定,咬合接触良好;E:术后即刻全颌曲面断层片,示种植体位置合适,有较好的平行度;F:术后3个月全颌曲面断层片,示种植体周围无明显骨吸收;G:术后1年复查全颌曲面断层片,示种植体周围无明显骨吸收。
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