Liệu pháp chống tiêu xương và sự sống còn của implant nha khoa: một nghiên cứu hồi cứu lên đến 20 năm ở phụ nữ

Springer Science and Business Media LLC - Tập 26 - Trang 6569-6582 - 2022
Yu-Chi Cheng1, Rolf Ewers2, Katherine Morgan3, Muneki Hirayama3, Laura Murcko3, John Morgan3, Edmara T. P. Bergamo4, Estevam A. Bonfante4
1Department of Biology, Massachusetts Institute of Technology, Cambridge, USA
2University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
3Implant Dentistry Centre, Boston, USA
4Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil

Tóm tắt

Mục tiêu của nghiên cứu này là để điều tra ảnh hưởng của liệu pháp chống tiêu xương lên sự sống còn của các implant nha khoa dạng chân đế. Các bệnh nhân điều trị bằng phương pháp chống tiêu xương qua đường uống hoặc tiêm tĩnh mạch, cũng như các bệnh nhân không điều trị chống tiêu xương và nhóm chứng khỏe mạnh đã được đưa vào nghiên cứu hồi cứu này. Tổng cộng có 1472 implant được đặt ở 631 bệnh nhân postmenopause (tuổi trung bình: 66.42 ± 9.10 tuổi), những người đã được theo dõi trong thời gian lên đến 20 năm (8.78 ± 5.68 năm). Phân tích sống sót Kaplan–Meier được tiến hành, và hồi quy Cox univariate và multivariate, phân cụm theo từng bệnh nhân, được sử dụng để đánh giá và nghiên cứu các yếu tố ảnh hưởng đến sự sống sót của implant. Các implant được đặt ở bệnh nhân điều trị bằng liệu pháp chống tiêu xương đường uống có tỷ lệ sống sót cao hơn đáng kể so với các implant được đặt ở nhóm chứng loãng xương/giảm mật độ xương (giá trị p < 0.001), và tỷ lệ sống sót tương tự khi so với nhóm chứng khỏe mạnh (giá trị p = 0.03). Thêm vào đó, phân tích hồi quy Cox univariate và multivariate phân cụm cũng cho thấy tỷ lệ sống sót cao hơn của implant khi sử dụng thuốc chống tiêu xương đường uống (giá trị p = 0.01 và 0.007, tương ứng), và tỷ lệ sống sót thấp hơn khi có sự hiện diện của loãng xương/giảm mật độ xương không được điều trị (giá trị p = 0.002 và 0.005, tương ứng). Tổng thể, tỷ lệ sống sót của implant sau 20 năm ở những bệnh nhân loãng xương đang điều trị bằng thuốc chống tiêu xương là 94%. Đối với các implant thất bại, những implant được thay thế mới ở bệnh nhân dưới liệu pháp chống tiêu xương có tỷ lệ sống sót sau 10 năm là 89%. Tỷ lệ sống sót lâu dài của implant dạng chân đế ở bệnh nhân loãng xương đang dùng thuốc chống tiêu xương đường uống tương tự như ở population khỏe mạnh và cao hơn đáng kể so với nhóm chứng không điều trị. Những kết quả này cho thấy rằng các implant dạng chân đế cung cấp một giải pháp vững chắc cho việc điều trị mất răng ở những bệnh nhân đang điều trị bằng liệu pháp chống tiêu xương.

Từ khóa


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