측방 접근법으로 상악동 골이식을 시행한 임플란트의 임상 예후와 위험인자에 대한 연구

Abstract

Abstract

Purpose: The aim of this study was to investigate the outcome of dental implants placed in a grafted maxillary sinus and identify possible risk factors for implant failure, and whether there are specific surgical or clinical conditions in which autogenous bone (AB) grafts are more favorable than bone substitutes (BSs) grafts for maxillary sinus floor augmentation (MSFA).

Materials and Methods: The author retrospectively analyzed 386 implants after MSFA in 178 patients. The outcome variables were 1) 2-, 5-, and 10-year cumulative survival rate of the implant, 2) risk factors for implant failure, and 3) correlation between preoperative residual bone height (RBH) and graft materials in terms of implant survival. Graft materials used were divided into five different groups: autogenic, allogenic, xenogenic, combination of allogenic and xenogenic, or combination of autogenic and xenogenic graft. To investigate risk factors for implant failure in MSFA, implant survival according to graft materials, patients' sex and age, surgical site, RBH, healing period prior to prosthetic loading, staged- or simultaneous implantation with MSFA, the crown-to-implant ratio, prosthetic type, implant diameter, and opposite dentition were evaluated.

Results: The cumulative 2-, 5-, and 10-year survival rates of implants placed in the grafted sinus (independent of the graft material used) were 98.4%, 97.1%, and 96.04%, respectively. In regions with a residual bone height of 5.0mm or less, greater RBH was preferable for long-term implant survival (odds ratio=3.475; p=0.035). Implant survival was not significantly different between graft materials, even when RBH was unfavorable.

Conclusions: The placement of dental implants with MSFA is a reliable procedure. Further, RBH is an important predictor of long-term implant survival. There was no specific surgical conditions in which AB was superior to BSs in terms of implant survival after MSFA.