임플란트 주위염의 유병률 및 위험요소분석에 관한 후향적 연구 = Prevalence and risk factors of peri-implantitis: A retrospective study

국문 초록 (Abstract)

목적: 본 연구의 목적은 최근 5년간 식립된 임플란트 증례를 대상으로 임플란트 주위염의 유병률을 조사하고, 질환 발생에 영향을 미칠 수 있는 요소들을 분석, 평가하는 것이다. 대상 및 방법: 2012년 1월 1일부터 2016년 12월 31일까지 이화여자대학교 의과대학 부속 목동병원 치과진료부 치주과에 내원한 환자 중 본원에서 임플란트를 식립하고 보철수복을 시행한 환자 422명(853개 임플란트)에 대한 의료기록과 방사선 사진을 바탕으로 임플란트 주위염의 유병률을 조사하고 임플란트 주위염에 영향을 미칠 수 있는 요소와의 연관성을 분석하였다. 각 위험요소와 임플란트 주위염의 통계적 연관성을 분석하기 위해 일반화추정방정식(generalized estimation equations, GEE)을 사용하여 각 변수들과 임플란트 주위염의 발생 사이 상관관계를 평가하였다. 또한 관찰 기간 중 임플란트 주위염의 누적 유병률은 Kaplan Meier Method를 사용하였다. 결과: 임플란트 주위염의 유병률은 환자 수준에서 7.3% (422명 중 31명), 임플란트 수준에서 5.5% (853개 중 47개)로 나타났다. 성별, 골유도재생술(guided bone regeneration, GBR)여부, 보철물 부하기간이 임플란트 주위염의 발생과 통계적 상관관계를 갖는 것으로 나타났다. 부하기간에 따른 임플란트 주위염의 누적 유병률을 분석한 결과 보철물 장착 후 19개월째 첫 임플란트 주위염이 발생하였고, 이후로 임계점(critical point) 없이 위험도는 시간에 따라 전반적으로 상승하는 양상을 보였다. 결론: 임플란트 주위염의 유병률은 환자수준에서 7.3%, 임플란트 수준에서 5.5%로 나타났으며, 남성, GBR을 시행한 경우, 보철물 부하기간이 길수록 임플란트 주위염의 발생 위험도가 증가한다.

참고문헌 (Reference)

1 박웅규, "유지치주치료의 환자 순응도에 대한 후향적 연구" 대한치주과학회 39 (39): 59-70, 2009

2 Schmitt A, "The longitudinal clinical effectiveness of osseointegrated dental implants for single-tooth replacement" 6 : 197-202, 1993

3 Atieh MA, "The frequency of peri-implant diseases : a systematic review and meta-analysis" 84 : 1586-1598, 2013

4 Ong CT, "Systematic review of implant outcomes in treated periodontitis subjects" 35 : 438-462, 2008

5 Vouros ID, "Systematic assessment of clinical outcomes in bone-level and tissue-level endosseous dental implants" 27 : 1359-1374, 2012

6 Berglundh T, "Soft tissue reaction to de novo plaque formation on implants and teeth. An experimental study in the dog" 3 : 1-8, 1992

7 Fransson C, "Severity and pattern of periimplantitis-associated bone loss" 37 : 442-448, 2010

8 Cordioli G, "Removal torque and histomorphometric investigation of 4 different titanium surfaces : an experimental study in the rabbit tibia" 15 : 668-674, 2000

9 Qian J, "Reasons for marginal bone loss around oral implants" 14 : 792-807, 2012

10 Rinke S, "Prevalence of periimplant disease in partially edentulous patients : a practice-based cross-sectional study" 22 : 826-833, 2011

11 Ferreira SD, "Prevalence and risk variables for peri-implant disease in Brazilian subjects" 33 : 929-935, 2006

12 Marcantonio C, "Prevalence and possible risk factors of periimplantitis : A concept review" 16 : 750-757, 2015

13 Derks J, "Peri-implantitis-onset and pattern of progression" 43 : 383-388, 2016

14 Heitz-Mayfield LJ, "Peri-implant diseases : diagnosis and risk indicators" 35 : 292-304, 2008

15 Schou S, "Outcome of implant therapy in patients with previous tooth loss due to periodontitis" 17 : 104-123, 2006

16 Brånemark PI, "Osseointegration and its experimental background" 50 : 399-410, 1983

17 Roos-Jansåker AM, "Nineto fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions" 33 : 290-295, 2006

18 Zitzmann NU, "Long-term results of implants treated with guided bone regeneration : a 5-year prospective study" 16 : 355-366, 2001

19 Bränemark PI, "Intra-osseous anchorage of dental prostheses. I. Experimental studies" 3 : 81-100, 1969

20 Esposito M, "Interventions for replacing missing teeth:different types of dental implants" CD003815-, 2007

21 Peñarrocha-Diago MA, "Influence of implant neck design and implant-abutment connection type on peri-implant health. Radiological study" 24 : 1192-1200, 2013

22 Quirynen M, "Infectious risks for oral implants : a review of the literature" 13 : 1-19, 2002

23 van der Weijden GA, "Implant therapy in partially edentulous, periodontally compromised patients : a review" 32 : 506-511, 2005

24 Higuchi KW, "Implant survival rates in partially edentulous patients : a 3-year prospective multicenter study" 53 : 264-268, 1995

25 Albrektsson T, "Implant survival and complications. The Third EAO consensus conference 2012" 23 : 63-65, 2012

26 Quirynen M, "Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis" 34 : 805-815, 2007

27 Renvert S, "How do implant surface characteristics influence peri-implant disease?" 38 : 214-222, 2011

28 Gotfren K, "Histomorphometric and removal torque analysis for TiO2-blasted titanium implants. An experimental study on dogs" 3 : 77-84, 1992

29 Gotfren K, "Histological and histomorphometrical evaluation of tissue reactions adjacent to endosteal implants in monkeys" 2 : 30-37, 1991

30 Padial-Molina M, "Guidelines for the diagnosis and treatment of periimplant diseases" 34 : e102-e111, 2014

31 Lindhe J, "Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology" 35 : 282-285, 2008

32 Greenstein G, "Failed dental implants : diagnosis, removal and survival of reimplantations" 145 : 835-842, 2014

33 Pontoriero R, "Experimentally induced peri-implant mucositis. A clinical study in humans" 5 : 254-259, 1994

34 Zitzmann NU, "Definition and prevalence of peri-implant diseases" 35 : 286-291, 2008

35 Hermann JS, "Crestal bone changes around titanium implants. A radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible" 68 : 1117-1130, 1997

36 Lang NP, "Consensus statements and recommended clinical procedures regarding implant survival and complications" 19 : 150-154, 2004

37 Albektsson T, "Consensus report of session IV" Quintessence Publishing 365-369, 1994

38 McDermott NE, "Complications of dental implants : identification, frequency, and associated risk factors" 18 : 848-855, 2003

39 Saadoun AP, "Clinical results and guidelines on Steri-Oss endosseous implants" 12 : 486-495, 1992

40 Krennmair G, "Clinical analysis of widediameter frialit-2 implants" 19 : 710-715, 2004

41 Pjetursson BE, "A systematic review of the survival and complication rates of fixed partial dentures(FPDs)after an observation period of at least 5 years" 15 : 667-676, 2004

42 Berglundh T, "A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years" 29 : 197-212, 2002

43 Jung RE, "A systematic review of the 5-year survival and complication rates of implant-supported single crowns" 19 : 119-130, 2008

44 Karoussis IK, "A comprehensive and critical review of dental implant prognosis in periodontally compromised partially edentulous patients" 18 : 669-679, 2007

45 Lee SY, "A 3-year prospective radiographic evaluation of marginal bone level around different implant systems" 37 : 538-544, 2010