种植体邻接与根管治疗牙生存率之间的关联
Association between implant adjacency and survival of endodontically treated teeth.
摘要(中文译文)
本回顾性队列研究评估了种植体邻接关系与根管治疗牙（endodontically treated teeth，ETT）生存率之间的关联，并评估了与垂直根折（vertical root fracture，VRF）导致牙齿丧失相关的因素。通过查阅患者病历识别与种植体相邻及不相邻的牙齿。主要结局为按牙齿位置和种植体邻接关系分层的ETT累积生存率。VRF为次要结局。采用Kaplan-Meier分析及log-rank检验比较生存率，并采用多变量logistic回归结合广义估计方程处理聚类效应。共纳入787例患者，包括2,048颗相邻牙和15,637颗非相邻牙（平均随访时间：57.1个月）。在1,119颗ETT中，生存率最高的为非相邻前牙（126.5个月），其次为非相邻后牙（84.8个月）、相邻前牙（55.6个月）和相邻后牙（44.4个月）（p < 0.001）。63颗ETT（5.63%）因VRF而丧失。与种植体相邻的ETT发生VRF的比值比显著更高（aOR = 8.90；95% CI，4.03-19.64；p < 0.001），且桩核放置与风险增加独立相关。种植体邻接关系和后牙位置与ETT生存率降低相关。种植体邻接关系和桩核放置与VRF导致牙齿丧失的风险增加独立相关。与牙种植体相邻的ETT可能生存率降低，尤其是在后牙区域。临床医生应意识到这些牙齿发生VRF的风险增加，尤其是在存在桩核放置的情况下。仔细的咬合管理和定期随访可能有助于降低牙齿丧失的风险。
Abstract
This retrospective cohort study evaluated the association between implant adjacency and survival of endodontically treated teeth (ETT) and assessed factors associated with tooth loss due to vertical root fracture (VRF). Patient charts were reviewed to identify teeth adjacent and nonadjacent to implants. The primary outcome was cumulative survival of ETT by tooth location and implant adjacency. VRF was the secondary outcome. Kaplan-Meier analysis with log-rank tests compared survival, and multivariable logistic regression with generalized estimating equations accounted for clustering. A total of 787 patients with 2,048 adjacent and 15,637 nonadjacent teeth were included (mean follow-up: 57.1 months). Among 1,119 ETT, survival was highest in nonadjacent anterior teeth (126.5 months), followed by nonadjacent posterior (84.8 months), adjacent anterior (55.6 months), and adjacent posterior teeth (44.4 months) (p < 0.001). Sixty-three ETT (5.63%) were lost due to VRF. ETT adjacent to implants had significantly higher odds of VRF (aOR = 8.90; 95% CI, 4.03-19.64; p < 0.001), and post placement was independently associated with increased risk. Implant adjacency and posterior location were associated with reduced survival of ETT. Implant adjacency and post placement were independently associated with an increased risk of tooth loss due to VRF. ETT adjacent to dental implants may have reduced survival, particularly in posterior regions. Clinicians should be aware of the increased risk of VRF in these teeth, especially when post placement is present. Careful occlusal management and regular follow-up may help mitigate the risk of tooth loss.
如何引用
AMA
Hsuan-Hung Chen, Yu-Ting Yeh, Ava Nazeri, Yi-Ching Ho, Guo-Hao Lin, Richard T Kao. Association between implant adjacency and survival of endodontically treated teeth.. Clinical oral investigations. 2026; doi:10.1007/s00784-026-07000-9.
APA
Hsuan-Hung Chen, Yu-Ting Yeh, Ava Nazeri, Yi-Ching Ho, Guo-Hao Lin, Richard T Kao (2026). Association between implant adjacency and survival of endodontically treated teeth.. Clinical oral investigations. https://doi.org/10.1007/s00784-026-07000-9
GB/T 7714
Hsuan-Hung Chen, Yu-Ting Yeh, Ava Nazeri, Yi-Ching Ho, Guo-Hao Lin, Richard T Kao. Association between implant adjacency and survival of endodontically treated teeth.[J]. Clinical oral investigations, 2026 doi:10.1007/s00784-026-07000-9.
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