种植冠桥修复体特征对植体周病发病影响的前瞻性临床研究  

Prospective clinical study on the influence of implant crown and bridge prostheses characteristics on peri-implant disease

作　　者：田敏[1] 赵芮 黄瑾 吉兆华 方明[1] 董岩[1] 陈莉 牛丽娜[1] 陈吉华[1] Tian Min;Zhao Rui;Huang Jin;Ji Zhaohua;Fang Ming;Dong Yan;Chen Li;Niu Lina;Chen Jihua(Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Xi′an 710032,China;Department of Epidemiology,School of Public Health,Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment,Air Force Medical University,Xi′an 710032,China)

机构地区：[1]第四军医大学口腔医学院口腔修复科,军事口腔医学国家重点实验室,口腔疾病国家临床医学研究中心,陕西省口腔医学重点实验室,西安710032 [2]空军军医大学军事预防医学系军队防疫与流行病学教研室特殊作业环境危害评估与防治教育部重点实验室,西安710032

出　　处：《中华口腔医学杂志》2021年第12期1197-1204,共8页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81720108011,81571013)。

摘　　要：目的探讨种植冠桥修复体不同特征对植体周病发病的影响,为临床制订植体周病防控措施提供参考。方法纳入2014年6月至2015年9月于第四军医大学口腔医学院口腔修复科行种植冠桥修复的患者,建立前瞻性队列,通过调查问卷和临床检查收集患者基本信息以及修复体的固位方式、邻接触情况、咬合情况等种植体和修复体相关因素及口腔卫生维护情况,并进行定期随访。采用Log-rank检验比较各因素对植体周病发病风险的影响,应用Cox比例风险回归模型分析各因素与植体周病发病风险的关联。结果共纳入214例患者,351枚植体,随访(11.0±3.5)个月。最终43.0%(92/214)的患者和37.3%(131/351)的种植体发生植体周病,植体周黏膜炎和植体周炎的患者水平发病率分别为41.1%(88/214)和4.2%(9/214),种植体水平发病率分别为34.2%(120/351)和3.1%(11/351)。在种植体和修复体相关因素中,单因素分析显示,修复体的固位方式、邻接状况、咬合情况与植体周病的发病有关联(P<0.05);Cox比例风险回归模型多因素分析显示,螺丝固位(风险比=2.38,95%CI:1.42~3.99)、修复体邻接丧失(风险比=2.36,95%CI:1.31~4.27)为植体周病发病的独立危险因素(P<0.05)。结论种植冠桥修复体的固位方式与邻接状况对植体周病的发生有重要影响。Objective To investigate the influence of different characteristics of implant-supported fixed dental prostheses on the incidence of peri-implant disease.Methods Prospective cohort was established for patients who received implant-supported fixed dental prostheses at the Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University between June 2014 and September 2015.Several patient-related factors,implant prostheses factors,and oral hygiene maintenance factors were collected.The Log-rank test was used to compare the peri-implant disease rates of various factors,and the Cox proportional hazards model was used to conduct multivariate study on single factor significant factors to analyze the impact on the incidence of peri-implant disease.Results A total of 214 subjects and 351 implants were included in the cohort,the follow-up period was(11.0±3.5)months.Finally,43.0%(92/214)of patients and 37.3%(131/351)of implants developed peri-implant diseases.The incidence of peri-implant mucositis and peri-implantitis was 41.1%(88/214)and 4.2%(9/214)at the subject level,and 34.2%(120/351)and 3.1%(11/351)at the implant level.Among the factors associated with the implant prosthesis,single factor Log-rank analysis showed that prostheses retention methods,proximal contact of the prostheses,occlusion situation were statistical significance(P<0.05).Multivariate analysis using Cox proportional hazards model showed that screw retention(hazard ratio=2.38,95%CI:1.42-3.99),proximal contact loss of the prostheses(hazard ratio=2.36,95%CI:1.31-4.27)were independent risk factors for peri-implant disease(P<0.05).Conclusions Factors such as prostheses retention mode and proximal contact characteristics have important influence on the health status of the implant.

关 键 词：牙种植体 牙冠(假体) 牙周疾病 发病率 队列研究 植体周病 

分 类 号：R783.6[医药卫生—口腔医学]