Miha Pirc^*; Ronald E. Jung; Christoph H. F. Hämmerle; Daniel Stefan Thoma

Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zürich, Switzerland

Background: Dental implant therapy, being predominantly an elective therapeutic treatment option, is associated with relatively high costs. Considering that supportive maintenance care is strongly recommended, additional regular costs and costs due to the treatment of potential complications need to be added and patients informed accordingly prior to the initiation of the therapy. However, a limited number of studies, not reflecting daily clinical practice, address the maintenance costs of implant therapy.

Aim/Hypothesis: To assess the costs and efforts of maintenance therapy following implant treatment with fixed restorations over an observation period of 8 years.

Material and Methods: Sixty-four patients were randomly assigned to receive one of two implant systems (S1 or S2) and eventually fixed restorations. Patients were included in a regular maintenance program according to their individual needs and were examined at loading (T_L), one (T₁), three (T₃), five (T₅) and eight years (T₈). Outcome measures included implant and restoration survival, probing depth (PD), bleeding on probing (BOP), plaque control record (PCR), technical and biological complications and radiographic bone levels. In addition, time, efforts and costs to treat biological and technical complications were measured and calculated.

Results: In total 97 implants were placed (S1: 54, S2: 43). The overall regular maintenance time amounted to 77.1 minutes and 372 CHF per year and patient. The most common technical complication was screw-loosening (43.75% of all complications). Technical complications were, in general, resolved within one appointment (mean = 1.4 ± 2.56). The most time-consuming complication was screw fracture (84 ± 37.7 min). The mean cost to treat the technical complication was 108 CHF per patient. The prevalence of biological complications was 23.71% on the implant and 23.44% on the patient level. Three implants were explanted (S1: 1, S2: 2). The treatment of biological complications required a mean of 1.3 appointments (peri-implant mucositis 1.5 appointments, peri-implantitis 3 appointments). The highest costs were associated with biological complication when the implant had to be removed (543 CHF per removal, 26 CHF per patient), whereas other interventions were performed during regular maintenance visits.

Conclusion and Clinical implications: Additional regular maintenance costs and costs due to the treatment of potential complications have to be taken into consideration when placing dental implants. The majority of technical complications could be resolved within one appointment, whereas the time needed to treat biological complications varied between one appointment for peri-implant mucositis and three appointments for peri-implantitis.

Disclosure of Interest: None Declared

Keywords: dental implants, implant-supported restorations, technical complications

米哈皮尔克^* ; 罗纳德·E·荣格；Christoph HF Hämmerle；丹尼尔·斯特凡·托马

瑞士苏黎世苏黎世大学牙科医学中心重建牙科诊所

背景：种植牙治疗主要是一种选择性治疗选择，但成本相对较高。考虑到强烈推荐支持性维护护理，需要增加额外的常规费用和因潜在并发症的治疗而产生的费用，并在开始治疗前相应地通知患者。然而，有限数量的研究并未反映日常临床实践，涉及种植体治疗的维护成本。

目的/假设：在 8 年的观察期内，评估固定修复体种植体治疗后维持治疗的成本和工作量。

材料和方法： 64 名患者被随机分配接受两种种植体系统（S1 或 S2）中的一种，并最终固定修复体。患者根据他们的个人需要被纳入定期维护计划，并在负荷 (T _L )、一年 (T ₁ )、三年 (T ₃ )、五年 (T ₅ ) 和八年 (T ₈ ) 时接受检查。结果指标包括种植体和修复体存活率、探诊深度 (PD)、探诊出血 (BOP)、斑块控制记录 (PCR)、技术和生物学并发症以及放射照相骨水平。此外，还测量和计算了治疗生物学和技术并发症的时间、努力和成本。

结果：总共植入了 97 个种植体（S1：54，S2：43）。整个定期维护时间为每年 77.1 分钟和 372 CHF。最常见的技术并发症是螺钉松动（占所有并发症的 43.75%）。一般而言，技术并发症在一次预约内得到解决（平均值 = 1.4 ± 2.56）。最耗时的并发症是螺钉断裂（84 ± 37.7 分钟）。治疗技术并发症的平均成本为每位患者 108 瑞士法郎。植入物的生物并发症发生率为 23.71%，患者水平为 23.44%。植入了三个种植体（S1：1，S2：2）。生物并发症的治疗平均需要 1.3 次预约（种植体周围粘膜炎 1.5 次预约，种植体周围炎 3 次预约）。

结论和临床意义：在放置牙种植体时，必须考虑额外的定期维护成本和潜在并发症的治疗成本。大多数技术并发症可以在一次预约内解决，而治疗生物并发症所需的时间在一次预约种植体周围粘膜炎和三次预约种植体周围炎之间有所不同。

利益披露：无申报

关键词: 牙种植体，种植体支持修复，技术并发症