DOI QR코드

DOI QR Code

상악동 거상술을 동반한 상악구치부에 식립된 임플란트 생존율에 대한 후향적 연구

The retrospective study of survival rate of implants with maxillary sinus floor elevation

  • 김범진 (단국대학교 치과대학 구강악안면외과학교실) ;
  • 이재훈 (단국대학교 치과대학 구강악안면외과학교실)
  • Kim, Beom-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University) ;
  • Lee, Jae-Hoon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University)
  • 투고 : 2010.03.04
  • 심사 : 2010.04.06
  • 발행 : 2010.04.30

초록

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

키워드

참고문헌

  1. Noack N, Willer J, Hoffmann J. Long-term results after placement of dental implants: longitudinal study of 1,964 implants over 16 years. Int J Oral Maxillofac Implants 1999;14:748-55.
  2. Adell R, Lekholm U, Rockler B, Bra􀆆nemark PI. A 15-year study of osseointegrated implants in the treatment of edentulous jaw. Int J Oral Surg 1981;10:387-416. https://doi.org/10.1016/S0300-9785(81)80077-4
  3. Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, et al. Osseointegrated oral implants. A Swedish multicenter study of 8,139 consecutively inserted Nobelpharma implants. J Periodontol 1988;59:287-96. https://doi.org/10.1902/jop.1988.59.5.287
  4. Adell R, Eriksson B, Lekholm U, Bra􀆆nemark PI, Jemt T. Longterm follow-up study of osseointegrated implants in the treatment of the totally edentulous jaw. Int J Oral Maxillofac Impalnts 1990;5:347-59.
  5. Chanavaz M. Maxillary sinus: anatomy, physiology, surgery and bone grafting related to implantology-eleven years surgical experience (1979-1990). J Oral Implantol 1990;16:199-209.
  6. Mish CE. Bone character: second vital implant criterion. Dent Today 1998;7:39-40.
  7. Friberg B, Sennerby L, Roos J, Lekholm U. Identification of bone quality in conjunction with insertion of titanium implants. A pilot study in jaw autopsy specimens. Clin Oral Impants Res 1995;6:213-9. https://doi.org/10.1034/j.1600-0501.1995.060403.x
  8. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 1980;38:613-6.
  9. Tatum H Jr. Maxillary and sinus implant reconstructions. Dent Clinics of North America 1986;30:207-29.
  10. Summers RB. The osteotome technique: part 3-less invasive methods of elevating the sinus floor. Compendium 1994;15:698, 700, 702-4 passim; quiz 710.
  11. Kahnberg KE, Ekestubbe A, Grondahl K, Nilsson P, Hirsch JM. Sinus lifting procedure. I. One-stage surgery with bone transplant and implants. Clin Oral Implants Res 2001;12:479-87. https://doi.org/10.1034/j.1600-0501.2001.120508.x
  12. del Fabbro M, Testori T, Francetti L, Weinstein R. Systematic review of survival rates for implants placed in the grafted maxillary sinus. Int J Periodontics Restorative Dent 2004;24:565-77.
  13. Wennerberg A, Albrektsson T, Andersson B, Krol J. A histomorphometric and removal torque study of screw-shaped titaninum implants with three different surface topographies. Clin Oral Implants Res 1995;6:24-30. https://doi.org/10.1034/j.1600-0501.1995.060103.x
  14. Buser D, Nydegger T, Oxland T, Cochran DL, Schenk RK, Hirt HP, Snetivy D, Nolte LP. Interface shear strength of titanium implants with a sandblasted and acid-etched surface: a biomechanical study in the maxilla of miniature pigs. J Biomed Mater Res 1999;45:75-83. https://doi.org/10.1002/(SICI)1097-4636(199905)45:2<75::AID-JBM1>3.0.CO;2-P
  15. Cochran DL. A comparison of endosseous dental implant surfaces. J Periodontol 1999;70:1523-39. https://doi.org/10.1902/jop.1999.70.12.1523
  16. Jensen OT, Shulman LB, Block MS, Iacono VJ. Report of the sinus consensus conference of 1996. Int J Oral Maxillofac Impalnts 1998;13(S):11-45.
  17. Tidwell JK, Blijdorp PA, Stoelinga PJ, Brouns JB, Hinderks F. Composite grafting of the maxillary sinus for placement of endosteal implants. A preliminary report of 48 patients. Int J Oral Maxillofac Surg 1992;21:204-9. https://doi.org/10.1016/S0901-5027(05)80219-X
  18. Yildirim M, Spiekermann H, Biesterfeld S, Edelhoff D. Maxillary sinus augmentation using xenogenic bone substitute material Bio-Oss in combination with venous blood. A histologic and histomorphometric study in humans. Clin Oral Implants Res 2000;11:217-9. https://doi.org/10.1034/j.1600-0501.2000.011003217.x
  19. Del Fabbro M, Testori T, Francetti L, Weinstein R. Systematic review of survival rates for implants placed in the grafted maxillary sinus. Int J Periodontics Restorative Dent 2004;24:565-77.
  20. Kent JN, Block MS. Maxillary sinus floor bone grafting and placement of hydroxylapatite-coated implants. J Oral Maxillofac Surg 1989;47:238-42. https://doi.org/10.1016/0278-2391(89)90225-5
  21. Block MS, Kent JN. Sinus augmentation for dental implants: the use of autogenous bone. J Oral Maxillofac Surg 1997;55:1281-6. https://doi.org/10.1016/S0278-2391(97)90185-3
  22. van Steenberge D, Quirynen M, Naert I. Survival and success rates with oral endosseous implants. In: Lang NP, Karring T, Lindhe J, eds. Proceedings of the 3rd European Workshop on Periodontology: implant dentistry; 1999 Jany 30-Feb 3; Charter House at Ittingen Thurgau, Switzerland: Berlin Quintessence Publishing Co; 1999:246-54.
  23. Albrektsson T, Zarb G, Worthington P, Eriksson AR. The longterm efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:11-25.
  24. Misch CE. Contemporary Implant Dentistry. 2nd ed. St. Louis: Mosby; 1998:91-123.
  25. Rosenberg ES, Cho SC, Elian N, Jalbout ZN, Froum S, Evian CI. A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report. Int J Oral Maxillofac Implants 2004;19:873-9.
  26. Branemark PI, Hansson BO, Adell R, Breine U, Lindstro ¨m J, Halle′n O, et al. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl 1977;16:1-132.
  27. Zarb GA, Schmitt. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part I: surgical results. J Prosthet Dent 1990;63:451-7. https://doi.org/10.1016/0022-3913(90)90237-7
  28. Albrektsson T, Branemark PI, Hansson HA, Lindstrom J. Osseointegrated titanium implants. Requirements for ensuring a long lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981;52:155-70. https://doi.org/10.3109/17453678108991776
  29. Wallace SS, Froum SJ. Efect of maxillary sinus augmentation on the survival of endosseous dental implants. A systematic review. Ann Periodontol 2003;8:328-43. https://doi.org/10.1902/annals.2003.8.1.328
  30. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999;81:537- 52. https://doi.org/10.1016/S0022-3913(99)70208-8
  31. Higuchi KW, Folmer T, Kultje C. Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. J Oral Maxillofac Implants 1995;53:264-8. https://doi.org/10.1016/0278-2391(95)90222-8
  32. Shin SH, Kim JR, Park BS. Bone formation around titanium impalnts in the tibiae of streptozotocin induced diabetic rats. J Korean Assoc Maxillofac Plast Reconstr Surg 2000;22:522-41.
  33. Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failure rates and associated risk factors. Int J Oral Maxillofac Implants 2005;20:569-77.
  34. Hurzeler MB, Kirsch A, Ackermann KL, Quinones CR. Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation. Int J Oral Maxillofac Implants 1996;11:466-75.
  35. Block MS, Kent JN. Maxillary sinus bone grafting. In: Block MS, Kent JN, eds. Endosseous implants for maxillofacial reconstruction. Philadelphia, PA: WB Saunders Co.; 1995:478-503.
  36. Wood RM, Moore DL. Grafting of the maxillary sinus with intraorally harvested autogenous bone prior to implant placement. Int J Oral Maxillofac Implants 1988;3:209-14.
  37. Misch CE, Dietsh F, Bone-grafting materials in implant dentistry. Implant Dent 1993;2:158-67. https://doi.org/10.1097/00008505-199309000-00003
  38. Valentini P, Abensur D, Maxillary sinus floor elevation for implant placement with demineralized freeze-dried bone and bovine bone (Bio-Oss): a clinical study of 20 patients. Int J Periodontics Restorative Dent 1997;17:232-41.
  39. van den Bergh JP, ten Bruggenkate CM, Krekeler G, Tuinzing DB. Maxillary sinusfloor elevation and grafting with human demineralized freeze dried bone. Clin Oral Implants Res 2000;11:487-93. https://doi.org/10.1034/j.1600-0501.2000.011005487.x
  40. Hallman M, Cederlund A, Lindskog S, Lundgren S, Sennerby L. A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation. Results after 6 to 8 months of healing. Clin Oral Implants Res 2001;12:135-43. https://doi.org/10.1034/j.1600-0501.2001.012002135.x
  41. Hallman M, Sennerby L, Lundgren S. A clinical and histologic evaluation of implant integration in the posterior maxilla after sinus floor augmentation with autogerous bone, bovine hydroxyapatite, or a 20:80 mixture. Int J Oral Maxillofac Implants 2002; 17:635-43.
  42. Loukota RA, Isaksson SG, Linne′r EL, Blomqvist JE. A technique for inserting endosseous implants in the atrophic maxilla in a single stage procedure. Br J Oral Maxillofac Surg 1992;30:46- 9. https://doi.org/10.1016/0266-4356(92)90136-7
  43. Ioannidou E, Dean JW. Osteotome sinus floor elevation and simultaneous, non-submerged implant placement: Case report and literature review. J Periodontol 2000;71:1613-9. https://doi.org/10.1902/jop.2000.71.10.1613
  44. Toffler M. Minimally invasive sinus floor elevation procedures for simultaneous and staged implant placement. N Y State Dent J 2004;70:38-44.
  45. Zitzmann NU, Scharer P. Sinus elevation procedures in the resorbed posterior maxilla. Comparison of the crestal and lateral approaches. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85:8-17. https://doi.org/10.1016/S1079-2104(98)90391-2
  46. Tarnow DP, Wallace SS, Froum SJ, Rohrer MD, Cho SC. Histologic and clinical comparision of bilateral sinus floor elevations with and without barrier membrane placement in 12 patients: part 3 of an ongoing prospective study. Int J Periodontics Restorative Dent 2000;20:117-25.
  47. Froum SJ, Tarnow DP, Wallace SS, Rohrer MD, Cho SC. Sinus floor elevation using anorganic bovine bone matrix (OsteoGraf/N) with and without autogenous bone: a clinical, histologic, radiographic, and histomorphometric analysis--Part 2 of an ongoing prospective study. Int J Periodontics Restorative Dent 1998;18:528-43.
  48. Bidez MW, Misch CE. Force transfer in implant dentistry: basic concepts and prinsples. J Oral Implantol 1992;18:264-74.
  49. Enkling N, Nicolay C, Utz KH, Johren P, Wahl G, Mericske- Stern R. Tactile sensibility of single-tooth implants and natural teeth. Clin Oral Implants Res 2007;18:231-6. https://doi.org/10.1111/j.1600-0501.2006.01321.x
  50. Chung DM, Oh TJ, Lee J, Misch CE, Wang HL. Factors affecting late implant bone loss: a retrospective analysis. Int J Oral Maxillofac Implants 2007;22:117-26.

피인용 문헌

  1. Retrospective Study of Bone Resorption after Maxillary Sinus Bone Graft vol.4, pp.2, 2011, https://doi.org/10.5856/jkds.2011.4.2.59
  2. 상악동 거상술을 동반한 임플란트 식립 후 지연성으로 발생한 상악동염에 대한 고찰 vol.35, pp.1, 2010, https://doi.org/10.14402/jkamprs.2013.35.1.060
  3. 원광대학교 산본치과병원에서 770명의 환자에 식립한 2158개의 골유착성 임플란트의 보철 전 초기 생존율에 관한 후향적 연구 vol.30, pp.4, 2010, https://doi.org/10.14368/jdras.2014.30.4.278
  4. The impact of the alveolar bone sites on early implant failure: a systematic review with meta-analysis vol.46, pp.3, 2010, https://doi.org/10.5125/jkaoms.2020.46.3.162