| Objective: The purpose of this study was to analyze the effect of smoking history,periodontitis history,position of missing teeth and other factors on the marginal bone loss around soft tissue level implants in posterior-tooth areas,to analyze the correlation between each factor and marginal bone loss,to provide the basis for formulation of prevention and treatment measures of marginal bone loss around implants,so as to provide guidance for improving the success rate of dental implants,maintaining the long-term stability of implants and selecting the indications.Methods: A retrospective study was conducted to collect clinical and radiographic datas of 124 implants in 80 patients who received and completed soft tissue level implants restoration in the posterior-tooth areas from January 2015 to January 2018 in the Department of Dental Implantation,Affiliated Hospital of Qingdao University.Record the general characteristics of patients,periodontal status,types of implants,implant sites,prosthesis type,the mobility of implants and prostheses,the survival rate of implants and prostheses.Digora image analysis software was used to measure the vertical distances between the shoulder plane of the dental implant and the crest level of the alveolar ridge in the immediate and 12-24 months follow-up X-ray films.The SPSS 25.0 software was used to analyze the single factor of each factor,and then binary logistic regression analysis was used to analyze the factors with statistically significant difference in single factor analysis.Results: Eighty patients(124 implants)were followed up,including 36 males and 44 females,with an average age of 41.6 years old(22-76 years old).No implant or prosthesis loosening,breaking or falling off was found.Univariate analysis showed that sex,smoking history,periodontitis history,position of missing teeth and width of attached gingival were risk factors for marginal bone loss around soft tissue level implants in posterior-tooth areas.Multivariate analysis showed that smoking history(P=0.018),moderate and severe periodontitis history(P=0.008),position of missing teeth(P=0.020)were independent risk factors for marginal bone loss.The risk of MBL≥1.5mm in smoking was 5.720 times higher than that in non-smoking(OR=5.720,95% CI:1.342-24.377).The risk of MBL≥ 1.5mm in moderate and severe periodontitis was 6.495 times higher than that in periodontal health(OR=6.495,95%CI:1.631-26.156).The risk of MBL≥1.5mm in maxillary position was 5.256 times higher than that in mandible position(OR=5.2565,95%CI:1.300-21.246).Conclusion:(1)Smoking history is an independent risk factor for marginal bone ioss around soft tissue level implants in posterior-tooth areas.Marginal bone loss in smoking patients was significantly higher than that in non-smoking patients.It is suggested that smokers should quit smoking before and after operation,which is beneficial to osseointegration of implant.(2)Moderate and severe periodontitis is another independent risk factor for marginal bone loss of soft tissue level implants in posterior-tooth areas.There was no significant difference between mild periodontitis patients and periodontal health patients.It is suggested that complete and systematic periodontal treatment before dental implantation,strict observation after operation,regular implant maintenance treatment and periodontal maintenance treatment are necessary for patients with history of moderate to severe periodontitis.(3)The location of missing teeth is an independent risk factor for marginal bone loss around soft tissue level implants in posterior-tooth areas.It is suggested that reduction of diameter,reduction of occlusion,elimination of premature contact and occlusal interference,application of consistent crowns,modified adhesion retention and other methods can be used to reduce occlusal force and avoid lateral force,which is conducive to the preservation of marginal bone. |
PDF Full Text Request