影响微种植体正畸治疗成功率的因素  

Factors affecting the clinical success rate of miniscrew implants for orthodontic treatment

作　　者：吴也可[1] 郜然然 左渝陵[1] 余剑锋[1] 赵立星[3] 聂汶涵 郑涛[4] 艾黄萍 严航 Wu Yeke;Gao Ranran;Zuo Yuling;Yu Jianfeng;Zhao Lixing;Nie Wenhan;Zheng Tao;Ai Huangping;Yan Hang(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China;Henan Provincial People's Hospital,Zhengzhou 450000,Henan Province,China;West China Hospital of Stomatology,Sichuan University,Chengdu 610041,Sichuan Province,China;Clinical Medical College,Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China)

机构地区：[1]成都中医药大学附属医院,四川省成都市610072 [2]河南省人民医院,河南省郑州市450000 [3]四川大学华西口腔医院,四川省成都市610041 [4]成都中医药大学临床医学院,四川省成都市610072

出　　处：《中国组织工程研究》2020年第4期538-543,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81500818)，项目负责人：吴也可;国家自然科学基金(81574035,81873334)，项目参与者：吴也可~~

摘　　要：背景:在正畸治疗过程中,影响微种植体临床成功率的潜在危险因素的相关报道结果不尽一致,一些临床医师非常关注的影响因素未全部纳入研究,且动物实验所得结论难以直接运用于临床实践。因此,究竟哪些因素影响微种植体的临床成功率,亟待进一步深入、系统的研究。目的:研究影响正畸支抗用微种植体临床成功率的相关因素。方法:试验纳入114例口腔种植患者,其中男42例,女72例,年龄(19.26±9.19)岁,共植入253枚微种植体作为正畸支抗。纳入以下影响因素:包括性别、年龄、垂直和矢状骨面型、植入位点、植入牙弓、植入部位软组织类型、口腔卫生状况、微种植体的直径和长度、植入方式、植入角度、应力加载时机和强度及临床用途,运用logistic回归分析研究成功率和所有变量间的相关性,方差分析检测各变量对成功率的影响。试验方案经过四川大学伦理委员会批准。结果与结论:(1)253枚微种植体的总临床成功率为88.54%,平均应力加载时长为9.5个月,其中29枚植入失败,植入失败微种植体的平均加载时长为2.3个月;(2)在卡方检验、Fisher精确检验和logistic回归分析中,年龄、口腔卫生状况、垂直骨面型及植入位点与临床成功率显著相关(P<0.05),而性别、矢状骨面型、植入牙弓、植入部位软组织类型、微种植体的直径和长度、植入方式、植入角度、应力加载时机和强度及临床用途11个变量与种植成功率无显著相关性(P>0.05);(3)结果提示为了最大程度降低微种植体失败率,需给予患者正确的口腔卫生保健指导和有效监督,特别是年轻(<12岁)、高角、下颌骨植入微种植体的患者。BACKGROUND: During the orthodontic treatment, the results of related reports on potential risk factors affecting the clinical success rat e of miniscrew implants are inconsistent. The influential factors that clinicians concern are not all incl uded in this study, and the conclusions from animal experiments are difficult to apply to clinical practice directly. Therefore, what factors affect the clinical success rate of miniscrew implants need further thorough and systematic research. OBJECTIVE: To investigate the factors that influence the clinical success rate of miniscrew implants used as orthodontic anchorage. METHODS: A total of 114 patients with oral implants, including 42 males and 72 females, aged(19.26±9.19) years were included in this study. A total of 253 miniscrew implants were implanted as orthodontic anchorage. The following influential factors were included: g ender, age, vertical skeletal facial pattern, implant site, implant arch, soft tissue type at the implant site, oral hygiene status, diameter and length of the miniscrew implants, implantation method, implantation angle, stress loading timing and intensity, and clinical use. Logistic regression analysis was used to study the correlation between success rate and all variables. Analysis of variance was used to test the effect of each variable on clinical success rate. This trial protocol was approved by the Medical Ethics Committee of Sichuan University. RESULTS AND CONCLUSION: Among 253 successful miniscrew implants, the overall success rate was 88.54% with an average loading period of 9.5 months. The average loading period of the 29 failed miniscrew implants was 2.3 months. The chi-square test, Fisher exact test and Logistic regression revealed that age, oral hygiene, vertical skeletal facial pattern, and implant site were significantly correlated with clinical success rate(P<0.05). However, gender, sagittal bone facial patter, implant arch, soft tissue type at implant site, diameter and length of miniscrew implant, implantation method, impla

关 键 词：微种植体 临床成功 多因素回归分析 正畸支抗 影响因素 种植成功率 LOGISTIC回归分析 

分 类 号：R459.9[医药卫生—治疗学] R783.5[医药卫生—临床医学]